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RN Utilization Review – Remote

November 8, 2021 by Vanessa Best

Precision is an Equal Opportunity Employer. We are committed to providing an environment of mutual respect where equal employment opportunities are available to all applicants without regard to race, color, religion, sex, pregnancy, national origin, age, physical and mental disability, marital status, sexual orientation, gender identity, gender expression, genetic information, military and veteran status, and any other characteristic protected by applicable law.

Join our growing team of RN Utilization Quality Reviewers. Team members will complete the full spectrum of activities related to Utilization or Quality reviews as assigned. They will utilize their knowledge and expertise of the review program to support Medical Review Analysts, Program Review Associates and Physician Consultants to ensure an appropriate and accurate process.

Job is 100% Remote, but requires two week paid training in New York.

DUTIES:

  • Conduct utilization reviews up to and including the appeal level. This includes chart screen, complete electronic worksheets, enter required information and make referral decisions when necessary.
  • Conduct quality and clinical study data collection reviews. This includes chart review, complete detailed electronic data worksheets.
  • Act as a resource for the PSC/clerical staff in training, problem solving, and clarifying procedures. Will provide technical assistance and conduct/participate in staff huddles.
  • Participate in collaborative training specific to clinical study objectives.
  • Other activities as may be deemed necessary.

QUALIFICATIONS:

  • Licensed as a Registered Professional Nurse in New York State.
  • Ability to oversee, problem solve and work collaboratively with peers, medical, analytical and administrative support staff.
  • Excellent written and verbal skills.
  • Ability to work independently with little supervision.
  • Ability and desire to be flexible, innovative and creative.

EDUCATION & EXPERIENCE:

  • Licensed as a Registered Professional Nurse in New York State, required.
  • Graduate of an approved Registered Professional Nurses training program or Baccalaureate degree in Nursing, required.
  • A minimum of two years’ experience in an acute care facility preferably in medicine/surgery or special care units; and/or one to three years’ experience in acute care utilization review, required.
  • Knowledge and experience with electronic medical records including utilization and clinical charting, required.

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Positions: RN Utilization Review
Locations: Remote
Grouping: Health Care Specialist

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Baldwin, NY
PO Box 1239
Baldwin, NY 11510
P (516) 771-7554
Atlanta, GA
260 Peachtree NW, Suite 2200
Atlanta, GA 30303
(844) HUB-ZONE

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1701 Pennsylvania Avenue NW,
Suite 200
Washington, DC 20006
(202) 960-4420

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  • Home
  • About Us
    • About PHCC
    • PHCC in the News
    • Awards
    • Testimonials
    • Case Studies
  • Services
    • Government Contracting Federal, State, City
    • PAS – Personal Assistant Services
    • HealthCare Administration
    • Health & Safety Services including COVID-19
    • Construction Support Services
    • Workforce Development Services
      • Precision Internship Program
    • PHCC Health Equity
    • Protocol/Clinical Trials Support
    • CME Courses
  • Training
    • OSHA Safety Training
    • On-Line Safety/HR Training Portal – Spanish Course Available
    • Traveling Medical Coding School
    • On Site / Remote Training
    • Workforce Development
      • Precision Internship Program
    • Small Business Development
    • Medical Coding Certificate Program – Online School
  • Contact
  • Blog
  • Careers