Sr Review Coordinator

Integrated Management Strategies, LLC

9d • Remote

About The Position

Integrated Management Strategies (IMS) is seeking an experienced Sr Review Coordinator to join their healthcare consulting practice. This role is fully remote within the US. The Senior Review Coordinator will 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. This position directly impacts the MD population's access to services and ensures they receive adequate support to remain at home. Training for this role will take place remotely and is expected to last approximately 4-6 weeks during standard business hours, with duration dependent on the individual.

Requirements

• Active Maryland RN License (OR) Social Worker License
• 3 – 5 years of recent experience working in a clinical environment
• Ability to maintain regular and predictable attendance
• Good written and oral communication skills

Nice To Haves

• Prior UM experience
• Knowledge of medical coding and billing
• Durable Medical Equipment experience
• Discharge planning experience
• Typing and data entry skills
• Familiarity with computer systems
• Use of multiple monitor work systems

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/or URAC requirements
• Screen situations according to specific criteria to determine if care is appropriate
• Ensure review is conducted thoroughly and within specified timeframes
• Serve as liaison among providers, facilities, and/or subscribers
• Document medical information supporting decisions into the workflow documentation system, ensuring data is entered accurately and timely

What This Job Offers

• Job Type: Full-time
• Career Level: Senior
• Education Level: No Education Listed