Clinical Reviewer (RN) Job at ISLAND PEER REVIEW ORGANIZATION INC, Jericho, NY

WUtzbFFOY0RZU0NnSEs3MDJTWlpkbHpiUGc9PQ==
  • ISLAND PEER REVIEW ORGANIZATION INC
  • Jericho, NY

Job Description

Job Description

Job Description

As a Clinical Reviewer, you will complete the full spectrum of activities related to Utilization or Quality reviews as assigned. You will utilize their knowledge and expertise of the review program to conduct clinical level review, supporting Medical Review Analysts, and Physician Consultants to ensure an appropriate and accurate process. Duties include but are not limited to:

  • Conduct utilization reviews up to and including the appeal level. This includes chart screen, complete electronic worksheets, enter required information and make level one denial 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 administrative 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.

QUALIFICATIONS:

  • Knowledge and experience with electronic medical records including utilization, quality, and clinical charting.
  • 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:

  • New York State, Licensed Registered Nurse, required.
  • A bachelor’s degree in Nursing OR graduate of an approved Registered Professional Nurses training program and licensed to practice in the State of New York, required.
  • Minimum of two (2) years’ experience in an acute care facility preferably in medicine/surgery or special care units; and/or one (1) to three (3) years experience in acute care utilization review.

The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. The hourly rate for this position is $38.461 - $43.269. Actual salary and/or hourly rate depends on a variety of factors including experience, education, credentials, location, and budget.

The salary range and/or hourly rate listed does not include other forms of compensation or benefits.

IPRO is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, protected veteran status or military status.

Job Tags

Hourly pay, Flexible hours,

Similar Jobs

AdventHealth Wesley Chapel

Registered Nurse Med Surg Unit with Telemetry 2 Job at AdventHealth Wesley Chapel

 ...~ Pet Benefits Schedule: Full time Shift: Day (United States of America) Address: 2600 BRUCE B DOWNS BLVD City...  ...safety standards, and regulatory requirements to maintain a safe healthcare environment. * Provide emotional support and therapeutic... 

HHS

Executive Chef / Restaurant Manager - Relocation Assistance Available Job at HHS

Job Description Build a well-trained and motivated team that produces high-quality food while adhering to safety, sanitation, and service principles Provide leadership that supports a team environment that fosters morale, passion, quality, and respect Develop...

Turner Staffing Group

Haul Truck Driver Job at Turner Staffing Group

 ...Turner Staffing Group Haul Truck Driver You You want to work for a services company that is rapidly changing the way the largest...  ...initiatives concurrently. Responsibilities: Operate and drive heavy haul trucks to transport tons of materials over short... 

Compunnel

Database Administrator Job at Compunnel

 ...customers for data migration projects. # Provide production support, capacity management, and maintain high availability & disaster recovery for large-scale databases. # Work with scripting languages such as shell scripts and Python. # Manage incident, change, and... 

Fred Haas Companies

Sales Consultant - Fred Haas Toyota Country Job at Fred Haas Companies

 ...Job Description Job Description Sales Consultant Fred Haas Toyota Country Full-Time | Houston, TX We are currently seeking highly motivated and results-driven Sales Consultants to join our dynamic dealership team. This is an excellent opportunity for individuals...