Nursing Specialist
20 hours ago
We are seeking a dedicated and skilled healthcare professional to join our team.
The ideal candidate will possess a strong background in nursing, with experience in utilization management and provider appeals reviews. Additionally, they should have excellent communication and problem-solving skills, as well as the ability to work effectively in a fast-paced environment.
Job Responsibilities:
- Conduct thorough reviews of medical records to ensure compliance with URAC standards and client requirements.
- Analyze data to identify areas for improvement and implement changes to optimize patient outcomes.
- Develop and maintain strong relationships with healthcare providers and clients to ensure effective communication and collaboration.
- Stay up-to-date with industry developments and best practices to continuously improve skills and knowledge.
Requirements:
- Bachelor's degree in Nursing or related field.
- NCLEX certification.
- Active USRN Mainland license and NMI License.
- At least 1 year hospital experience.
Benefits:
- Work from home opportunity.
- Fixed weekends off.
- Night shift schedule available.
What We Offer:
- A dynamic and supportive work environment.
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