Clinical Reviewer Nurse
Integrated Home Care Services, Inc.•Miramar, FL
About The Position
Integrated Home Care Services (IHCS) is seeking a Clinical Reviewer Nurse, described in the posting as a Utilization Management Nurse. The role helps ensure that home health care services are delivered with quality, cost efficiency, and compliance. The nurse reviews and audits patient treatment files to help prevent unnecessary procedures, ineffective treatment, and unnecessarily extensive home healthcare.
Requirements
- State licensure as a Licensed Practical Nurse (LPN) or Registered Nurse (RN).
- At least 2 years of prior experience in Utilization Management.
- Strong knowledge of word processing and spreadsheet computer programs.
Nice To Haves
- Utilization Management or Case Management certification.
Responsibilities
- Conduct concurrent reviews of patient clinical information for efficiency.
- Review precertification requests on an ongoing basis for medical necessity.
- Coordinate patient care needs with a multidisciplinary healthcare team.
- Maintain accurate records of patient-related interactions.
- Provide updates to the Manager of Utilization Management for review.
- Stay organized and interact well with others in any situation.
Benefits
- Medical, vision, and dental insurance.
- Short- and long-term insurance.
- Six or more days of holiday pay.
- Paid time off (PTO).
- Employer-paid life insurance.
- 401(k) with employer contribution.
- Wellness program with reward incentives.
- Employee recognition and reward programs.
- Comprehensive paid training program.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
