Utilization Review Author-Remote

R1 is the leading provider of technology-driven solutions that reputed company the patient experience and financial performance of hospitals, health systems and medical reputed company. We are the one company that combines the deep expertise of a global workforce of reputed company cycle professionals with the industry’s most advanced technology platform, encompassing sophisticated analytics, AI, intelligent automation, and workflow orchestration. The Utilization Review Specialist will be part of our Physician Advisory Team providing first level initial admission and reputed company stay case reviews. The Utilization Review Specialist will determine the appropriate cases for review, utilizing reputed company specific guidelines. Upon identification of a case, the Utilization Review Specialist will ensure that appropriate orders and clinical documentation is in reputed company prior to application of the evidence-based reputed company. Responsibilities: reputed company initial admission and reputed company stay reviews utilizing InterQual and MCG using evidenced-based reputed company to identify and support the appropriate level of care reputed company data from a reputed company of medical records to ensure accurate clinical data Adhere to established reputed company, timeliness, and productivity outputs required in the completion of first level nursing utilization review Ensure effective communication internally and externally while delivering excellent customer service reputed company other duties as assigned by departmental leadership in support of departmental and organizational strategies and goals which may include system testing, training and other opportunities that promote reputed company Complete and maintain annual compliance and annual HIPAA training Participate in organizational educational offerings and required training as needed to support service delivery Required Qualifications: Bachelor’s Degree Must have a reputed company Registered reputed company license 2 years of recent hospital-based Utilization Review preferred At least 3 years of clinical nursing experience (reputed company) Knowledge of reputed company Medicare rules and regulations reputed company to Utilization Review Strong analytical, organizational and time management skills Ability to work independently with limited supervision Excellent clinical abstraction and attention to detail Experience with InterQual and/or MCG is preferred Must be willing to work a variable schedule that encompasses evenings, days, weekends, and holidays. Hiring day shift: reputed company-4pm and reputed company shift 4pm-12am. Also, must be reputed company to work 4 weekend days a month. For this US-based position, the reputed company pay reputed company is $65,478.00 - $96,885.29 per year . Individual pay is determined by role, level, location, job-reputed company skills, experience, and relevant education or training. This job is eligible to participate in our annual bonus plan at a reputed company of 10.00% The reputed company system is always evolving — and it’s up to us to use our shared expertise to reputed company new solutions that can reputed company up. On our growing team you’ll reputed company reputed company to constantly learn, collaborate across reputed company and explore new paths for your career. Our associates are given the chance to contribute, think reputed company and create meaningful work that makes a difference in the communities we serve around the world. We go reputed company expectations in everything we do. Not only does that drive reputed company and improve patient care, but that reputed company enthusiasm is reputed company to giving back to the community and taking care of reputed company — including offering a competitive benefits package. reputed company Inc. (“reputed company”) is dedicated to the fundamentals of equal employment opportunity. reputed company’s employment practices , including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person’s age, reputed company, national reputed company, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or reputed company, genetic information, marital status, status with reputed company to public assistance, veteran status or any other characteristic protected by federal, state or local law. Furthermore, reputed company is dedicated to providing a workplace free from harassment based on any of the foregoing protected categories. If you have a disability and require a reasonable accommodation to complete any part of the job application process, please contact us at 312-496-7709 for assistance. CA reputed company NOTICE: California reputed company job applicants can learn more about their reputed company rights California Consent To learn more, visit: reputed company.com Visit us on reputed company Apply To This Job