Remote Nurse Reviewer - UM/QR Specialist

HCSC Group

Illinois

Hybrid

USD 70,000 - 126,000

Full time

7 days ago

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Benefits offered by this job

Remote work

Job summary

HCSC is seeking a Nurse Reviewer/Clinical Reviewer to ensure utilization management and quality review functions meet regulatory standards. The role requires an unrestricted RN license, 3 years clinical experience with 2 years in utilization review, and strong analytical and communication skills.

Travel including overnight stays may be required; sponsorship is not available. The position is remote and nationwide within the United States, with compensation between $69,800 and $125,900 per year

Qualifications

Unrestricted RN license and active practice eligibility.
Minimum 3 years of clinical experience, with 2 years in utilization review or quality assurance.
Strong clinical knowledge and understanding of UM/QR processes.
Excellent analytical, verbal, and written communication skills.
Valid Illinois driver's license and willingness to travel, including overnight stays.
Knowledge of managed care principles.

Skills

RN license

Clinical experience

Utilization review

Quality assurance

Medicare knowledge

Analytical communication

Willingness to travel

Job description

Travel including overnight stays may be required; sponsorship is not available. The position is remote and nationwide within the United States, with compensation between $69,800 and $125,900 per year

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