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Case Management Medical Review Nurse

Company: Nursing Careers
Location: Hillsboro
Posted on: October 12, 2018

Job Description:

A fantastic career opportunity for Medical Review Clinician is now available with a reputable Healthcare Management organization in beautiful and serene Northern of Oregon. If you enjoy a fun lifestyle in a moderate climate with many choices of outdoor activities, art scenes, wineries and great food, look no further!

The Medical Review Clinician will be part of an organization that provides medical peer review solutions to leading health insurance carriers, medical management organizations, TPAs and hospital groups. Their case review services power clinical decision-making processes for hundreds of clients nationwide, and through steady growth they are a recognized leader in this dynamic market.
The Medical Review Clinician will be responsible for assisting with the completion of medical reviews and hospital peer reviews. The Medical Review Clinician will be required to work in multiple phases of the production process to produce written reviews that meet URAC accreditation and internal established standards.

The Medical Review Clinician will support the work of physicians to maintain a high level of excellence in the production of independent medical reviews and hospital peer reviews. The Medical Review Clinician will work closely with our physicians and national peer specialist panel to provide written medical chart reviews and determinations.
The Medical Review Clinician should have BSN degree with RN license with day to day responsibilities in working at multiple phases of the review process, including:
• preparation of cases to ensure essential materials have been submitted
• coordination of documentation sent to reviewers
• writing clinical summaries and review/edit returned reviews
• ensuring the accuracy of determinations, by checking medical facts, and certifying quality and production parameters are met.
The organization is a place where employees are actively empowered to treat themselves and each other with respect and compassion. It has discovered that nurturing the caregivers provides them with the strength they need to be passionate about taking care of the patients – physically, emotionally and spiritually. Join now!!


Keywords: Nursing Careers, Portland , Case Management Medical Review Nurse, Executive , Hillsboro, Oregon

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