Remote Idaho Licensed Registered Nurse Clinical Reviewer

Job ID: Available for Members

Location: Nationwide

Compensation: To Be Discussed

Staff Reviewed: Tue, May 14, 2019

Job Category: Case Management, Healthcare, Nursing

Telecommute Level: Majority

Travel Requirements: Possible Travel

Weekly Hours: Full Time

Employment Status: Independent Contractor

Employer Type: Staffing Agency

Career Level: Experienced

Education Level: Some College

Job Summary

A staffing agency is seeking a Remote Idaho Licensed Registered Nurse Clinical Reviewer.

Candidates will be responsible for the following:

  • Working with managed care delivery systems
  • Overseeing discharge planning, medical/surgical inpatient/outpatient care
  • Overseeing occupational health, rehabilitation, orthopedic, or neurological surgical nursing

Applicants must meet the following qualifications:

  • Seven years’ clinical nursing to include three years’ health insurance experience
  • 1-2 years of experience in Coding (CPT, DRG, and ICD-10)
  • Active Idaho or Compact RN License
  • Proficient understanding of CMS benefits, regulations and reporting criteria
  • Knowledge of National Commission on Quality Assurance (NCQA) accreditation standards
  • Proficient understanding of benefits and contract requirements