Peer to Peer Nurse Author, RN

🔥 10 minutes ago

🇺🇸 United States – Remote

💵 $65.5k - $96.9k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

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R1 RCM

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 2017

💼 Consulting

📦 Logistics

🏥 Healthcare

💰 Private Equity Round on 2024-07

Consulting • Logistics • Healthcare

R1 RCM is a leading provider of revenue cycle management solutions for the healthcare industry. With an emphasis on maximizing financial performance and optimizing patient care, R1 offers a comprehensive platform that integrates data analytics, intelligent technologies, and deep expertise in revenue cycle management. The company assists healthcare providers—ranging from hospitals and health systems to physician and specialty care practices—in capturing revenue opportunities, improving payer and patient cash flows, and ensuring compliance with government regulations. R1 is committed to driving cost reductions and revenue improvements while enhancing the patient experience. Their suite of services includes revenue recovery, clinical integrity, and regulatory navigation, making them a trusted partner for many top healthcare providers.

📋 Description

• Review denied authorization cases and evaluate whether documentation supports the requested admission status, procedure, and care setting • Advise client hospitals on the appropriateness of authorization requests based on available documentation • Help increase clean claims submission and reduce accounts receivable days • Write clinical consultations evaluating requested authorizations, documentation support, evidence-based criteria, and the overall clinical request • Evaluate and interpret hospital documentation related to requested authorizations • Provide actionable root cause analysis feedback to client hospitals • Serve as a clinical resource to medical and case management staff • Provide written case analysis and perform reviews across multiple specialties

🎯 Requirements

• Active RN license • 3+ years of recent acute, hospital-based clinical experience in a medical/surgical unit, emergency department, and/or ICU • Strong clinical knowledge across multiple areas • Ability to work independently with a high level of performance in a fast-paced production environment • 1+ year of hospital-based utilization management experience is a plus

🏖️ Benefits

• Annual bonus plan at a target of 10.00% • Competitive benefits package • Opportunities to constantly learn, collaborate across groups, and explore new career paths • Meaningful work that makes a difference in communities • Equal employment opportunity • Reasonable accommodation for applicants with disabilities