Remote Senior Review Coordinator - Healthcare Utilization

Integrated Management Strategies, LLC; United States; Remote; USD 65,000 - 90,000; Full time

Job summary

Integrated Management Strategies, LLC is seeking an experienced Sr Review Coordinator for our healthcare consulting practice. This fully remote role within the United States focuses on utilization review of plans of service for home and community-based programs, supporting non-clinical reviewers, and ensuring timely, quality decisions to improve access to care.

The candidate will review complex plans of service, document decisions, and liaise with providers while maintaining strong communication

Qualifications

• Active Maryland RN License or Social Worker License.
• 3–5 years of recent clinical experience.
• Ability to maintain regular and predictable attendance.
• Good written and oral communication skills.
• Up to 5% local travel.

Responsibilities

• Perform utilization review of plans of service for home and community-based programs.
• Review complex plans of service and act as a resource for non-clinical reviewers.
• Provide independent review decisions for behavioral health services and the appropriateness of quality of care based on contract, state and URAC requirements.
• Screen situations according to criteria to determine if care is appropriate.
• Ensure reviews are conducted thoroughly within specified timeframes.
• Serve as liaison among providers, facilities, and subscribers.
• Document medical information supporting decisions in the workflow system clearly and timely.

Skills

Strong communication

Attention to detail

Time management

Remote work readiness

Education

RN License

Social Worker License

Tools

EHR software

Job description

Integrated Management Strategies, LLC is seeking an experienced Sr Review Coordinator for our healthcare consulting practice. This fully remote role within the United States focuses on utilization review of plans of service for home and community-based programs, supporting non-clinical reviewers, and ensuring timely, quality decisions to improve access to care.

The candidate will review complex plans of service, document decisions, and liaise with providers while maintaining strong communication