Senior Review Coordinator

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🕒 Setembro 3

🇺🇸 Estados Unidos – Remoto (EUA)

⏰ Tempo Integral

🟠 Sênior

🦅 Patrocina Visto H1B

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👻 Score fantasma 11%

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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ERM

5001 - 10000 funcionários

🏥 Saúde

📦 Logística

🏭 Manufatura

Healthcare • Logistics • Manufacturing

Sustentabilidade é o nosso negócio.

Descrição

• Perform utilization review of plans of service for home and community-based programs • Review complex plans of service and act as a resource for non-clinical reviewers • Provide independent review decisions for behavioral health services and assess appropriateness of quality of care • Screen situations according to specific criteria to determine whether care is appropriate • Ensure reviews are conducted thoroughly and within specified timeframes • Serve as liaison among providers, facilities, and/or subscribers • Document medical information supporting decisions in the workflow documentation system • Enter data accurately and timely • Participate in approximately 4–6 weeks of remote training during standard business hours

🎯 Requisitos

• Active Maryland RN License (OR) Social Worker License • 3–5 years of recent experience working in a clinical environment • Ability to maintain regular and predictable attendance • Good written and oral communication skills • Up to 5% local travel • Prior UM experience preferred • Knowledge of medical coding and billing preferred • Durable Medical Equipment experience preferred • Discharge planning experience preferred • Typing and data entry skills preferred • Familiarity with computer systems and use of multiple monitor work systems preferred • Ability to perform work according to contract, state and/or URAC requirements • E-Verify employment eligibility requirements

🏖️ Benefícios

• Fully remote within the US • Remote training • Equal opportunity employer committed to diversity and inclusion • Reasonable accommodation available for the employment process

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