Independent Review Specialist

Job Summary

A company is looking for a Contingent Independent Review Specialist (IDR/IIDR) to support case review processes remotely.

Key Responsibilities

• Complete IDR/IIDR case reviews in accordance with contract requirements and deadlines
• Manage assigned deliverables, ensuring accuracy, quality, and timeliness
• Maintain compliance with all applicable regulations, including HIPAA, FISMA, URAC, and CMS standards

Qualifications

• Experience in long-term care, assisted living, ICF/IID facilities, or related healthcare settings
• Knowledge of state and federal regulations governing healthcare facilities and services
• Experience with utilization review, case management, or healthcare review processes preferred
• Bachelor's degree or equivalent experience in utilization review, case management, or healthcare field required
• Nursing or related licensure preferred but not required