Remote RN Clinical Readmission Lead Auditor

Devoted; Northern (KY); À distance; USD 73 000 - 125 000; Plein temps

Avantages offerts par ce poste

Health insurance

Paid time off

Monthly mobile stipend

Stock options

Bonus eligibility

Résumé du poste

Devoted Health is seeking a Clinical Readmission Manager to conduct prepayment and post-payment reviews of inpatient admissions and related readmissions within 30 days, ensuring clinical relevance and compliance. The role requires RN licensure, 5+ years in clinical nursing or healthcare audit, strong documentation and collaboration across teams, with remote work and a competitive total rewards package.

You will apply guidelines, prepare defensible findings, support disputes and appeals, and help

Qualifications

• Must hold RN license in at least one U.S. state.
• 5+ years of clinical nursing, hospital-based care, healthcare audit, or related field.
• Experience reviewing inpatient readmissions and medical records.
• Strong analytical and documentation skills; ability to prepare clear, defensible rationales.
• Ability to work remotely and collaborate with multiple teams.

Responsabilités

• Conduct prepayment and post-payment clinical reviews of inpatient admissions and related readmissions within 30 days.
• Apply organizational policies, regulatory requirements, and readmission criteria.
• Prepare clear, objective clinical determinations and supporting documentation.
• Prepare initial findings, dispute responses, and appeal letters; review additional documentation.
• Collaborate with Payment Integrity, quality, utilization management, and other teams on complex cases.

Connaissances

RN license

Inpatient nursing

Medical record review

Readmission criteria

Analytical skills

Communication

Discharge planning

EMR/audit systems

Remote work experience

Cross-functional collaboration

Formation

BSN or related healthcare degree

Outils

EMR systems

Description du poste

Devoted Health is seeking a Clinical Readmission Manager to conduct prepayment and post-payment reviews of inpatient admissions and related readmissions within 30 days, ensuring clinical relevance and compliance. The role requires RN licensure, 5+ years in clinical nursing or healthcare audit, strong documentation and collaboration across teams, with remote work and a competitive total rewards package.

You will apply guidelines, prepare defensible findings, support disputes and appeals, and help