What are the responsibilities and job description for the Medical Review Nurse (Full-time, Remote) position at Integrity Management Services, Inc.?
About Us
Integrity Management Services, Inc. (IntegrityM) is an award-winning, women-owned small business specializing in assisting government and commercial clients in compliance and program integrity efforts, including the prevention and detection of fraud, waste and abuse in government programs. Results are achieved through data analytics, technology solutions, audit, investigation, and medical review.
At IntegrityM, we offer a culture of opportunity, recognition, collaboration, compassion and supporting our community. We thrive off of these fundamental elements that make IntegrityM a great place to work. Our small, flexible workplace offers an exceptional quality of life and promotes corporate-driven sustainability. We deliver creative solutions that exceed goals and foster a dynamic, idea-driven environment that nurtures our employees' professional development. Large company perks...Small company feel!
We are now seeking a Medical Review Nurse to join our team. Responsibilities may include research on medical claims data and other sources of information to identify problems, review sophisticated data model output, and utilize a variety of tools to detect situations of potential fraud and to support the ongoing fraud investigations and requests for information.
Requirements
Integrity Management Services, Inc. (IntegrityM) is an award-winning, women-owned small business specializing in assisting government and commercial clients in compliance and program integrity efforts, including the prevention and detection of fraud, waste and abuse in government programs. Results are achieved through data analytics, technology solutions, audit, investigation, and medical review.
At IntegrityM, we offer a culture of opportunity, recognition, collaboration, compassion and supporting our community. We thrive off of these fundamental elements that make IntegrityM a great place to work. Our small, flexible workplace offers an exceptional quality of life and promotes corporate-driven sustainability. We deliver creative solutions that exceed goals and foster a dynamic, idea-driven environment that nurtures our employees' professional development. Large company perks...Small company feel!
We are now seeking a Medical Review Nurse to join our team. Responsibilities may include research on medical claims data and other sources of information to identify problems, review sophisticated data model output, and utilize a variety of tools to detect situations of potential fraud and to support the ongoing fraud investigations and requests for information.
Requirements
- Current RN license or other professional medical license
- Nursing degree or other professional medical degree
- 2 years' clinical experience
- Demonstrated proficiency in Medical Review work
- Working knowledge of SNF and Medicare
- Excellent communication skills
- Demonstrated prioritization, problem solving, and organization skills
- Strong computer skills including Microsoft Office proficiency
- Enthusiastic individuals who can work effectively in a dynamic environment both in a team as well as independently is a must!
- All candidates MUST pass a background check and drug screening prior to employment.
