Job Description

:
Job Title - Clinical Reviewer Job Location - Remote Duration - 3+ Months Pay Rate - $43/hr. on w2 with no benefits
:
The purpose of this position is to utilize clinical expertise to review medical records against appropriate criteria in conjunction with contract requirements to determine medical appropriateness.
Responsibilities:
Assures accuracy and timeliness of all applicable review type cases within contract requirements
Assesses, evaluates, and addresses daily workload and queues; adjusts work schedules daily to meet the workload demands of the department
In collaboration with Supervisor, responsible for quality monitoring activities
Maintains current knowledge base related to review processes and clinical practices
Functions as providers' liaison for customer service issues and problem resolution
Performs all applicable review types as workload indicates
Fosters positive and professional relationships with internal and external customers
Attends training and scheduled meetings for current/updated information
Cross trains to provide flexible workforce to meet client/customer needs
Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules
Required Qualifications
Active and unrestricted Registered Nurse (RN) license for Oregon
Ability to be licensed for the State of Nebraska, if you don't currently hold a compact license
Bachelor's degree from an accredited college or university in a related field
2+ years of experience in Utilization Management or Clinical Review
Preferred Qualifications
Case management experience
Knowledge of medical records, medical terminology, and disease processes
Strong clinical assessment and critical thinking skills
Excellent written and verbal communication skills
Job Types: Full-time, Contract
Pay: $43.00 per hour
Expected hours: 40 per week
Schedule:
8 hour shift
Day shift
Monday to Friday
Experience:
Clinical Reviewer: 1 year (Required)
License/Certification:
RN License of Oregon (Required)
BLS Certification (Required)
Work Location: Remote

Job Tags

Hourly pay, Full time, Contract work, Temporary work, Remote work, Monday to Friday, Flexible hours, Shift work, Day shift

Similar Jobs

My Florida Corp Defunct

ADULT EDUCATION TEACHER Job at My Florida Corp Defunct

...ADULT EDUCATION TEACHER Date: Sep 14, 2026 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ( . Requisition No: 883309 Agency: Department of Corrections Working Title: ADULT EDUCATION TEACHER Pay Plan...

Hill Robinson

Yacht Administrator Job at Hill Robinson

...worlds largest superyachts, bringing technical excellence to a full spectrum of services. Today, Hill Robinson offers specialised yacht management, project management for new builds and refit, charter management, corporate services, crew placement, payroll and recruitment...

UTRS

System Administrator Job at UTRS

Universal Technical Resource Services, Inc. (UTRS) is currently seeking a System Administrator to join our team! At UTRS, we enjoy the benefits of working in a collaborative environment of close-knit team members. As a company, we provide a wide range of leading-edge engineering...

Albertsons

Night Crew Stocker Job at Albertsons

...facilities, and 19 manufacturing plants across 34 states and the District of Columbia. Our well-known banners include Albertsons, Safeway, Vons, Jewel-Osco, ACME, Shaw's, Tom Thumb, United Supermarkets, United Express, Randalls, Albertson's Market, Pavilions, Star Markets...

Paycom - ATS

Drill Rig Operator Job at Paycom - ATS

...We are seeking experienced Drill Rig Operators to join our team based in Raleigh, North Carolina. This role involves operating truck and track-mounted drill rigs (including CZM, Spiradrill, and Altec models) on various construction and geotechnical projects across the...

Clinical Reviewer Job at Akar IT services, Indiana