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Clinical Nurse Review Specialist

2 months ago


Warminster, United States National Medical Reviews Full time
Job Overview

Position Title: Clinical Nurse Review Coordinator

Work Arrangement: This role is remote.

Licensure Requirement: Active nursing license is mandatory.

Company Overview: National Medical Reviews, Inc. (NMR) is seeking a qualified Registered Nurse for a full-time salaried role focused on medical record evaluations. NMR is an URAC accredited Independent Review Organization dedicated to delivering high-quality, impartial, and prompt 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. The organization provides timely, unbiased, and expert assessments across a comprehensive range of utilization review services, including evaluations of medical necessity, experimental treatments, administrative issues, and quality of care challenges.

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 reports, leveraging clinical expertise while receiving training on procedural aspects.

Position Type: Hybrid work model available.

Key Responsibilities Include:

  • Engaging collaboratively via phone and electronic communication with industry professionals, including case managers and physician reviewers.
  • Producing comprehensive and well-structured reports.
  • Interacting with clients and resources nationwide.
  • Coordinating with non-clinical administrative support to maintain quality and adhere to strict timelines.

Qualifications:

  • Experience in Utilization Review or Utilization Management.
  • A diverse clinical background.
  • Exceptional written and verbal communication skills.
  • Proficiency in Microsoft Office Suite (Word, Excel, Access).
  • Strong organizational skills and meticulous attention to detail.

Educational Background:

  • Current Registered Nurse (RN) license.
  • A minimum of five years of clinical experience involving direct patient care.

Company Culture: NMR fosters a supportive, team-oriented environment with ongoing mentoring and training in medical records review and appeals procedures.

Benefits Offered:

  • Health, dental, and vision insurance.
  • Retirement plan.
  • Paid time off.

Ideal Candidate Traits:

  • Dependable and reliable.
  • Detail-oriented with a focus on accuracy.
  • Ability to thrive in high-pressure situations.

Job Type: Full-time

Salary Range: $60,000 - $65,000 annually.

Work Schedule: Monday to Friday, with specific shifts outlined.

Licensure Requirement: RN or LPN license is required.