Clinical Reviewer Nurse

Offering a competitive compensation package, including but not limited to;

Medical, Vision, Dental, Short- and Long-term insurance
6+ Days of Holidays Pay
PTO
Employer paid life insurance
401K with employer contribution
Wellness program with reward incentives
Employee recognition and reward programs
Comprehensive paid training program
What will you be doing:

As a Utilization Management Nurse, you will ensure that home health care services are administered with quality, cost efficiency, and within compliance. By continuously reviewing and auditing patient treatment files, the utilization nurse will ensure that patients won’t receive unnecessary procedures, ineffective treatment, or unnecessarily extensive home healthcare.

Concurrent review of patient’s clinical information for efficiency
Ongoing review of precertification requests for medical necessity
Coordinates patient care needs with a multi-disciplinary healthcare team
Maintain accurate records of all patient related interactions
Ability to stay organized and interact well with others in any situation
Provide updates to Manager of Utilization Management for review
What will you need to succeed:

State licensure as a LPN or RN
Minimum 2 years of prior experience in Utilization Management
Strong knowledge of word processing and spreadsheet computer programs
Utilization Management or Case Management certification preferred
Join our team as we strive for excellence through teamwork, where our patients are #1!

IHCS is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.

Qualifications
Behaviors
Preferred
Team Player: Works well as a member of a group
Enthusiastic: Shows intense and eager enjoyment and interest
Detail Oriented: Capable of carrying out a given task with all details necessary to get the task done well
Dedicated: Devoted to a task or purpose with loyalty or integrity
Motivations
Preferred
Ability to Make an Impact: Inspired to perform well by the ability to contribute to the success of a project or the organization
Growth Opportunities: Inspired to perform well by the chance to take on more responsibility
Experience
Required
Strong knowledge of word processing and spreadsheet computer programs
Utilization Management or Case Management certification preferred
2 years:
experience in Utilization Management
State licensure as a LPN or RN