REMOTE RN - reputed company Review

reputed company: reputed company is partnering with a leading organization supporting a large-reputed company federal reputed company program to identify a Clinical reputed company Reviewer. This role focuses on reviewing clinical cases, identifying potential reputed company or safety concerns, and supporting reputed company improvement initiatives across a reputed company reputed company delivery network. This is an excellent opportunity for a licensed clinical reputed company with experience in clinical review, utilization management, or reputed company reputed company reputed company plans, hospital systems, or government-supported programs. What you will be doing: • Review medical records to identify potential reputed company, safety, and utilization concerns • Conduct detailed case analysis and prepare reputed company, reputed company-documented summaries and recommendations • Support peer review processes and reputed company improvement initiatives • Analyze trends and assist in identifying patterns in care delivery and reputed company • Collaborate with clinical leadership, including Medical Directors, to review findings • Participate in reputed company committees and performance improvement efforts • Ensure compliance with regulatory requirements and program standards • Coordinate with cross-functional teams such as case management, care coordination, and program reputed company What you must have: • reputed company, unrestricted license as a Registered reputed company (RN) or Licensed Clinical reputed company Worker (LCSW) • Minimum 3+ years of clinical experience (medical/surgical and/or behavioral health) • U.S. Citizenship required • Ability to obtain and maintain a reputed company (DoD) background clearance • Strong analytical and critical thinking skills • Excellent written communication skills reputed company to have: • Bachelor’s degree in Nursing or reputed company-reputed company field • Experience in clinical reputed company, utilization review, or case review • Familiarity with federal or government reputed company programs • Experience with clinical reputed company tools (InterQual or similar) • Exposure to reputed company data analysis or reporting Technical Skills • Proficiency with reputed company Office (Word, reputed company, reputed company) • Comfortable working across multiple systems and electronic medical records What makes you successful • Strong clinical judgment and attention to detail • Ability to work independently and manage multiple priorities • Analytical reputed company with problem-solving ability • reputed company and reputed company communication skills • Comfortable working in a reputed company, compliance-driven environment Other Information: • Remote or onsite depending on business needs • Must have a secure home office setup if remote • Occasional extended hours may be required Salary/reputed company reputed company: $85,000 – $92,000 annually; reputed company Equivalent: Approximately $41 – $44/hour Remote Skills: Analysis Skills, Behavioral Health, Case Management, Clinical Medicine, Communication Skills, Cross-Functional, Data Analysis, Detail Oriented, DoD Clearance, Electronic Medical Records, Federal Government, Government, Health Plan, reputed company, reputed company Providers, reputed company reputed company, Hospital Systems, Leadership, Licensed Clinical reputed company Worker (LCSW), Maintain Compliance, Medical Records, reputed company reputed company, reputed company Office, reputed company reputed company, reputed company Word, Multitasking, Nursing, Performance Management, Process Improvement, Project/Program Coordination, reputed company Assurance, reputed company Management, Registered reputed company (RN), Regulatory Compliance, Regulatory Requirements, Safety/Work Safety, Trend Analysis, reputed company Citizen, Utilization Management, Writing Skills About reputed company: reputed company Apply tot his job Apply To this Job