Part Time Utilization Review Rn Jobs in Washington

LifeHealthLLC (LifeHealth), a professional services company specializing in worksite wellness services, clinical staffing, and healthcare readiness is looking for qualified Registered Nurses (RN) responsible for the initial chart review and chart case management for medical exam/screening programs to verify that all medical information and exam components are accurate. The
RN works directly with Physicians and Examinees to ensure all medical information is gathered andperforms medical Quality Assurance on all charts in various process stages leading to a final
determination.

• Position: Medical Review RN
• Date: Start Date - TBD
• Shift Time: 0800-1630 M-F
• Location: Washington, DC

Position Summary:

LifeHealth Medical Review Nurse (MRN) is responsible for the initial chart review and chart case management for medical exam/screening programs to verify that all medical information and exam components are accurate. The RN works directly with Physicians and Examinees to ensure all medical information is gathered and performs medical Quality Assurance on all charts in various process stages leading to a final determination.This position is temporary short-term position for 6-8 weeks with possible extension.

Essential Duties and Responsibilities include, but are not limited to the following:

• Performs medical review of incoming charts to determine if additional medical information is needed.
• Collaborates with Physician(s) and other internal nursing staff members f or chart review.
• Performs medical Quality Assurance (QA) on all charts in various process stages.
• Interfaces with Client's Medical Department as well as the on-site provider.
• Contacts Examinee via telephone or email to clarify information necessary to complete the chart.
• Develops a very good understanding of the specific contract's guidelines and addendums as required.
• Masters the various software programs specific to the functioning of the exam program.
• Implements and follows up on requests for further evaluation from the Examinee when required.
• Works closely with other departments to provide accurate and quality outcomes.
• Thoroughly cognizant of metrics and organizes workload to meet them.
• Consistently learns and applies codified state and federal regulations specific to particular contract(s).
• Serve as backup to other nurses f or daily duties and assists with follow-up calls to facilities and Examinees as needed as well as other duties as assigned.
• Opportunity to travel and assist on medical mobile events as either a site lead and/or RN as work orpersonal schedule permit.
• May participate in interdepartmental project groups or task forces to integrate activities, communicate issues, obtain approvals, resolve problems, and maintain a specif ic level of knowledge pertaining to new
  developments, new task efforts, contract awards, and new policy requirements.
• Supports marketing and sales objectives and efforts as requested.
• Performs duties in a safe manner. Follows the corporate safety policy. Participates and supports safety meetings, training, and goals. Ensures safe operating conditions within an area of responsibility.
  Encourages co-workers to work safely. Identifies "close calls" and/or safety concerns to supervisory
  personnel. Maintains a clean and orderly work area.
• Assists in the active implementation of company initiatives to ensure compliance with OSHA VPP, ISO,JCAHO, AAAHC, and other mandated regulations/standards.
• May serve on the OSHA VPP, Safety, and Wellness Committees.

Qualifications/Knowledge Skills & Abilities:

• 5-7 years of relevant experience.
• Fully unencumbered nursing license to work in Washington DC required.
• Proficiency with computer and common office equipment, as well as with MS Office products.
• Must be able to multitask, be flexible, be organized, and have excellent oral and written communicationskills as well as exceptional attention to detail.
• Ability to work independently and prioritize a moderate workload with minimal supervision
• Adaptability to schedule changes on an as-need basis
• Must beeligibleto work in theUS
• Must possessreliable transportation, have a clean driving record, and current automobile insurance.
• Must be 18 years of age or older
• Current CPR,BLS or ACLS

Disclaimer:

LifeHealthis an Equal Employment Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

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