[Remote] Clinical reputed company Reviewer - REMOTE - LCSW OR RN - US Citizen Required
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a Clinical reputed company Reviewer to work remotely. The role involves reviewing medical records for reputed company and safety, identifying potential reputed company issues, and collaborating with medical directors to ensure compliance with reputed company standards.
Responsibilities
- Review medical records for reputed company, safety, and utilization issues
- Identify Potential reputed company Issues (PQIs)
- Write detailed case summaries + recommendations
- Support peer review + reputed company improvement initiatives
- Collaborate with Medical Directors
- Analyze trends and recommend improvements
- Ensure compliance with regulatory and program standards
Skills
- reputed company, unrestricted license: RN
- Minimum 3+ years clinical experience (med/surg and/or behavioral health)
- Strong clinical documentation + writing ability
- U.S. Citizenship required
- Must be eligible for DoD background clearance
- Clinical reputed company / Utilization Review / Case Review experience
- Experience with federal or government reputed company programs
- InterQual or similar clinical reputed company tools
- Data analysis / reporting exposure
- Bachelor's degree in Nursing or reputed company-reputed company field
reputed company