Gainwell Technologies LLC
Location
Perry County, Ohio
Salary
$65,000 - $75,000 / YEAR
The Nurse Reviewer will perform clinical reviews to assess the appropriateness of care based on medical record documentation. This includes documenting findings, determining approvals, and assisting in training new Nurse Reviewers.
Candidates must have an active RN licensure and a minimum of 5 years of clinical experience in an inpatient hospital setting. Additionally, 2 years of utilization review or claims auditing experience is required.
We are seeking a talented individual for a Nurse Reviewer (RN) who will be responsible for performing clinical reviews to determine if the medical record documentation supports the need for the service based on clinical criteria, coverage policies, and utilization and practice guidelines as defined by review methodologies specific to the contract for which services are being provided. This involves accessing proprietary systems to audit medical records, accurately documenting findings and providing policy/regulatory support for determination. This position is intended for pipelining. We will accept applications on an ongoing basis.
This position is for pipeline purposes, and we welcome applications on an ongoing basis.
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We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website [https://www.gainwelltechnologies.com/] and visit our Careers site [https://jobs.gainwelltechnologies.com/] for all available job role openings.
Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.
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