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Clinical Nurse Review Specialist
2 months ago
Position Title: Clinical Nurse Review Coordinator
Work Arrangement: This role is remote.
Licensure Requirement: An active nursing license is mandatory.
Company Overview: National Medical Reviews, Inc. (NMR) is seeking a licensed Registered Nurse for a full-time, salaried role focused on medical record evaluations. NMR is a URAC accredited Independent Review Organization dedicated to delivering high-quality, objective, and efficient medical review services.
Core Responsibilities: NMR specializes in independent medical reviews addressing various benefit disputes and quality of care concerns in both medical management and workers' compensation contexts. Our services include prompt, unbiased, and expert opinions on a wide range of utilization review services, including medical necessity, experimental treatments, administrative issues, and quality of care assessments.
The Nurse Review Coordinator (RC) plays a crucial role in overseeing the case review process. The RC collaborates with administrative personnel and a panel of physician peer reviewers to address inquiries from clients. The RC is also responsible for ensuring the quality of the physician's report. Your clinical expertise is invaluable, and comprehensive training on our processes will be provided.
Position Type: Hybrid work model available.
Key Responsibilities Include:
- Engaging telephonically and electronically with industry professionals, including case managers and physician reviewers.
- Creating and delivering well-structured reports.
- Interacting with clients and resources nationwide.
- Coordinating with non-clinical administrative staff to maintain quality and adhere to strict timelines.
Qualifications:
- Experience in Utilization Review or Utilization Management.
- A broad clinical background.
- Exceptional written and verbal communication skills.
- Proficiency in Microsoft Office applications (Word, Excel, Access).
- Strong organizational skills and attention to detail.
Educational Background:
- Current Registered Nurse (RN) license.
- A minimum of five years of clinical experience with direct patient care.
NMR fosters a supportive, team-oriented work environment with ongoing mentoring. Training on medical record reviews and appeals procedures is included.
Benefits Offered:
- Health, dental, and vision insurance.
- Retirement plan options.
- Paid time off.
Company Culture:
- People-oriented, emphasizing support and fairness.
- Team-oriented, promoting cooperation and collaboration.
Ideal Candidate Traits:
- Dependable and reliable.
- Detail-oriented, focusing on specifics.
- Capable of thriving in high-pressure environments.
Job Type: Full-time
Salary Range: $60,000 - $65,000 annually.
Work Schedule:
- 8-hour shifts.
- Day shifts from Saturday to Wednesday.
Licensure/Certification:
- RN or LPN license required.
