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Nurse Reviewer
2 months ago
We are seeking a highly skilled and experienced Nurse Reviewer to join our team at Gainwell Technologies LLC. As a key member of our clinical review team, you will play a critical role in ensuring the quality and accuracy of our clinical review processes.
Key Responsibilities- Conduct thorough and accurate clinical reviews of medical records to determine the appropriateness and reasonableness of care.
- Apply critical thinking and decision-making skills to evaluate medical records and make informed decisions.
- Document decisions and rationale to justify review findings or no findings.
- Collaborate with cross-functional teams to ensure seamless communication and coordination.
- Stay up-to-date with current clinical guidelines, policies, and procedures to ensure compliance and quality.
- Active and unrestricted RN license required.
- 5+ years of clinical experience in an inpatient hospital setting required.
- 2+ years of utilization review experience or claims auditing required.
- Experience using Milliman or InterQual criteria required.
- Strong computer skills and typing abilities, including proficiency in Microsoft Windows, Outlook, Excel, Word, PowerPoint, and Internet browsers.
- A competitive salary range of $49,200 - $70,300 per year.
- A comprehensive benefits package, including health insurance, 401(k) employer match, and educational assistance.
- A flexible and remote work environment, with opportunities for career growth and development.
- A collaborative and inclusive work culture that values diversity, equity, and inclusion.
Gainwell Technologies LLC is a leading provider of healthcare technology solutions, dedicated to improving the quality and efficiency of healthcare services. We are committed to creating a diverse, equitable, and inclusive workplace, where all employees can thrive and grow.
