Registered Nurse - Program Review Associate
Job description
Amazing remote opportunities for Registered Nurse Program Review Associates with ARC Healthcare!
The PRA will complete the full spectrum of activities related to Utilization or Quality reviews as assigned by the client. PRA will utilize their knowledge and expertise of the review program to support the Medical Review Analysts, Program Review Associates and Physician Consultants to ensure an appropriate and accurate process. Extensive electronic communication knowledge, multi tasking, time management, and organizational skills are mandatory in this role. We encourage all RN's interested in this opportunity to apply today.
Shift: Days Monday - Friday
Wage: Competitive
Responsibilities:
- Conduct utilization reviews up to and including the appeal level. This includes:
chart screen, complete electronic worksheets, enter required information and make referral decisions when necessary
- Conduct quality and clinical study data collection reviews. This includes chart review, complete detailed electronic data worksheets.
- Act as a resource for the PSC/clerical staff in training, problem solving, and clarifying procedures. Will provide technical assistance and conduct/participate in staff huddles.
- Participate in collaborative training specific to clinical study objectives.
- Other activities as may be deemed necessary.
Qualifications:
- Licensed as a Registered Professional Nurse
- Valid state identification.
- Knowledge and experience with electronic medical records including utilization and clinical charting.
- Ability to oversee, problem solve and work collaboratively with peers, medical, analytical and administrative support staff.
- Excellent written and verbal skills.
- Ability to work independently with little supervision.
ARC Healthcare is an Equal Employment Opportunity/Affirmative Action Employer and does not discriminate on the basis of race, color, creed, religion, sexual orientation, sex, age, national origin, gender, gender identity, genetic information, uniform service, protected veteran status or disability, or any characteristic protected by federal, state, or local law with respect to employment opportunities.
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