Remote Quality Review RN's

Location: Salt Lake City, UT, USA

Salary: $35.00 USD Hourly - $36.00 USD Hourly

Description: Judge Healthcare is currently seeking a Remote Quality Review RN's for one of our biggest clients!

Type: Contract 3 months

Schedule

• Monday to Friday, with working hours between 7:00 AM and 7:00 PM Mountain Time (MT).
• Expect one late shift per week (10:30 AM to 7:00 PM MT).
• Rotating late shifts on Fridays, approximately once a month.
• Weekend shifts occur roughly once every six weeks.
  
  

Job Summary: Registered Nurses on this team handle a diverse array of cases from various clients, covering topics such as prenatal testing, surgical procedures, genetic testing, oncological cases, and more. Nurses should possess strong problem-solving abilities to independently address unique situations, applying skills learned during training to tackle new challenges.

Responsibilities

• Conduct quality audits of physician case reviews, evaluating clinical accuracy and completeness using national medical guidelines (e.g., MCG, InterQual).
• Ensure reviews are formatted according to specific requirements.
• Support the clinical components of the case review process.
• Address operational issues related to clinical review cases.
• Communicate with assigned reviewers, treating/ordering practitioners, and providers.
• Provide guidance to reviewers on case operations and review processes, offering relevant information for assigned cases.
• Collaborate with the Chief Medical Director and Director of Provider Relations to address reviewer quality issues and support the provider relations process.
• Meet or exceed established monthly production benchmarks.
  
  

Qualifications

• Active Compact/Multistate RN License required.
• Minimum of 4 years’ clinical nursing experience, with a preference for a broad scope of practice.
• Must have hospital bedside nursing experience in ICU, ER, Med/Surg, or Dialysis settings. Experience solely in OR, Pediatrics, Labor & Delivery, Women’s Services, etc., will not be considered.
• Permanent hospital experience (3 years) is required for candidates with travel RN backgrounds.
• Familiarity with Milliman or InterQual is a plus.
• Candidates must be available for 2 months of training and should not require extended time off within the first 3 months.
  
  

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Contact: bbishop@judge.com

This job and many more are available through The Judge Group. Find us on the web at www.judge.com