Clinical Reviewer - ONLY W2

nTech Workforce; McLean (VA); Remote; USD 80,000 - 110,000; Full time

Job summary

A leading company is seeking a Clinical Reviewer to utilize clinical expertise to review medical records and ensure appropriate care standards are met. This hybrid role requires a Bachelor's degree, RN licensure in Oregon, and a strong background in clinical review. Candidates will work directly with healthcare providers to resolve issues, assure accuracy in reviews, and maintain compliance with contract terms.

Qualifications

• 2+ years of experience in Utilization Management or Clinical Review.
• Active Registered Nurse (RN) license for Oregon required.
• Ability to get licensed for Nebraska if compact license not held.

Responsibilities

• Review medical records against criteria to determine medical appropriateness.
• Assure accuracy and timeliness of review type cases.
• Collaborate with supervisor for quality monitoring activities.

Skills

Clinical assessment

Critical thinking

Communication

Education

Bachelor's degree in a related field

Job description

Direct message the job poster from nTech Workforce

--------------------ONLY W2------------------ONLY W2-----------------ONLY W2------------------

Title: Clinical Reviewer

Location: McLean, VA 22102

Duration: 3 Months Contract + Extension

Job Description:

Terms of Employment

• W2 Contract, 3 Months
• Location: Remote
• Candidates must reside within the State of Oregon or bordering geographies

Overview

• The purpose of this position is to utilize clinical expertise to review medical records against appropriate criteria in conjunction with contract requirements to determine medical appropriateness.

Responsibilities:

• Assures accuracy and timeliness of all applicable review type cases within contract requirements
• Assesses, evaluates, and addresses daily workload and queues; adjusts work schedules daily to meet the workload demands of the department
• In collaboration with Supervisor, responsible for quality monitoring activities
• Maintains current knowledge base related to review processes and clinical practices
• Functions as providers' liaison for customer service issues and problem resolution
• Performs all applicable review types as workload indicates
• Fosters positive and professional relationships with internal and external customers
• Attends training and scheduled meetings for current/updated information
• Cross trains to provide flexible workforce to meet client/customer needs
• Read, understand, and adhere to all corporate policies including policies related to HIPAA and its Privacy and Security Rules

Required Skills & Experience

• Bachelor's degree from an accredited college or university in a related field
• 2+ years of experience in Utilization Management or Clinical Review
• Active and unrestricted Registered Nurse (RN) license for Oregon
• Ability to be licensed for the State of Nebraska, if you don't currently hold a compact license

Preferred Skills & Experience

• Knowledge of medical records, medical terminology, and disease processes
• Strong clinical assessment and critical thinking skills
• Excellent written and verbal communication skills

Preetam Raj

Lead Technical Recruiter

D: 410-505-4857 EXT: 726

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Contract

Job function

• Job function

  Analyst and Customer Service

• Industries

  Hospitals and Health Care

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