A staffing company is searching for a person to fill their position for a Remote Concurrent Review Nurse in St Louis. Core Responsibilities Include: Completing medical necessity and level of care reviews. Performing telephonic review request of medical claims.
A staffing agency needs applicants for an opening for a Remote HEDIS Review Special Projects Nurse in Cleveland. Individual must be able to fulfill the following responsibilities: Reviewing medical records for HEDIS/utilization review. Meeting productivity standards/metrics.
A degree from an accredited program of nursing. 4+ years Case Management or acute care coordination experience. Strong computer skills, proficient in Windows, Excel and prior use of a laptop. US Citizenship and the ability to pass federal security clearance screening.
Position Requirements Include: Bachelors Degree in Human Resources, or related field. 5+ years of relevant practitioner experience administrating and managing compensation and job data and programs. CCP, GRP or related professional certifications or credentials preferred.