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Clinical Nurse Reviewer
2 months ago
Company: TekWissen LLC
Position: Registered Nurse - Review Analyst
Work Type: Remote
Contract Duration: 9 Months
Department: Commercial Inpatient Services
Position SummaryTekWissen LLC is a prominent workforce management provider operating across the USA and internationally. Our client, a leading health insurance organization, offers a variety of healthcare coverage options, including individual and family plans, dental and vision coverage, as well as employer-sponsored plans.
Key ResponsibilitiesThe selected candidate will be responsible for conducting thorough reviews of patient cases to ensure compliance with established medical guidelines and protocols.
Essential Qualifications- Minimum of 2 years of experience in acute care settings with a valid Registered Nurse license.
- Experience in ICU or ER settings is preferred; candidates should not have solely specialized in areas such as NICU, OB, BH, or Substance Abuse.
- Familiarity with InterQual, MCG, or other utilization review methodologies.
- Proficient computer skills.
- Typing speed of 40+ words per minute.
- Previous utilization review experience in a health insurance environment, particularly with medical and surgical admissions.
- Experience in an acute care setting is highly desirable.
- Must possess an unrestricted Registered Nurse license.
TekWissen LLC is committed to fostering a diverse workforce and is an equal opportunity employer.
