Pennsylvania Licensed Clinical Reviewer
Job Summary
Collaborating with clinicians to ensure accurate documentation, the full-time Pennsylvania Licensed Clinical Reviewer will focus on documentation improvement, utilization management, and quality improvement while working remotely during standard business hours.
Key responsibilities
- Reviews clinical documentation for compliance with regulations and collaborates with clinicians to ensure accurate completion and effective care plans
- Collects and submits data for utilization management as needed
- Communicates with clinical effectiveness teams and department leadership to develop solutions for identified issues
Required qualifications
- Current RN license in Pennsylvania
- Bachelor of Science in Nursing (BSN) from an accredited school
- Minimum of 2 years of experience with Medicare regulations for OASIS, compliance, and coding
- Experience in home care criteria and processes
Complete Job Description
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