Offer summary

Qualifications:

Strong clinical background with the ability to evaluate clinical data and medical records., Attention to detail and organizational skills for reviewing medical documents., Certification in Case Management or Utilization Review is required., Advanced computer skills, including proficiency in Microsoft Office and data analysis tools..

Key responsibilities:

Critically evaluate clinical data and medical records for accuracy and compliance.

Review medical documents across multiple programs.

Manage multiple reviews and meet deadlines in a fast-paced environment.

Utilize various software tools for data analysis and reporting.

Job description

Will this position be required to work onsite for any reason at any time? NO, fully remote

Top 3 Required Skills/Experience –
• Strong Clinical Background - Ability to critically evaluate clinical data and medical records to ensure accuracy and compliance with utilization management/clinical decision support for Medicare Advantage member
• Attention to detail and organization skills - Reviewing the medical documents across multiple programs.
• Advanced Computer Skills - Proficiency in using various software tools and platforms for data analysis and reporting

Required Skills/Experience – The rest of the required skills/experience. Include:
• Certification in Case Management or Utilization Review - experience in the review process for post acute care settings ie Skilled Nursing Facility, Long Term Acute Care and / or Home Health Care.
• Time Management Skill - Ability to manage multiple reviews and meet deadlines in a fast-paced environment.
• Advanced Computer Skills – experience with various software tools, Microsoft Office and utilization of multiple monitors with WPM at minimum of 45-50.

Required profile