Oregon Licensed RN Reviewer

Job Summary

Working remotely, the Oregon Licensed RN Reviewer will conduct utilization management reviews to ensure appropriate patient care and resource utilization in a part-time capacity.

Key responsibilities

• Coordinate accurate patient status identification and documentation
• Ensure correct admission status and reimbursement through certification and clinical review
• Gather additional clinical documentation to validate treatment plans and level of care

Required qualifications

• Bachelor of Science in Nursing (BSN)
• 3+ years of acute care hospital experience with strong clinical knowledge
• In-depth understanding of Medicare/Medicaid UM regulations, RAC, QIO, MAC, and denial/appeals processes
• Active RN license in your state of residence (WA, OR, or AK)