Remote Utilization Review Rn Jobs in Carrollton, GA

Company Description
WHO IS GUIDEHEALTH?
Guidehealth is a data-powered, performance-driven healthcare company dedicated to operational excellence. Our goal is to make great healthcare affordable, improve the health of patients, and restore the fulfillment of practicing medicine for providers. Driven by empathy and powered by AI and predictive analytics, Guidehealth leverages remotely-embedded Healthguides™ and a centralized Managed Service Organization to build stronger connections with patients and providers. Physician-led, Guidehealth empowers our partners to deliver high-quality healthcare focused on outcomes and value inside and outside the exam room for all patients.
Join us as we put healthcare on a better path!!
Job Description
We are seeking a dedicated and compassionate Registered Nurse (RN) to join our team as a Telehealth Medicare Annual Wellness Visit Specialist - PRN. In this remote role, you will be responsible for conducting Medicare Annual Wellness Visits (AWVs) via telehealth under the direct supervision of a physician. This position focuses on preventive healthcare, patient education, and the assessment of individual health risks, all conducted through virtual platforms to promote better health outcomes for our Medicare population.
WHAT YOU'LL BE DOING

• Conducting Medicare Annual Wellness Visits via telehealth in accordance with CMS guidelines, ensuring all required assessments and screenings are completed.
• Virtually reviewing and updating patient medical histories, including medication lists, immunization records, and family history.
• Assessing patients' current health status, including vital signs when available, cognitive function, and risk factors for chronic diseases, utilizing remote monitoring tools when applicable.
• Providing patient education on preventive measures, lifestyle changes, and available community resources to promote overall health and well-being through virtual consultations.
• Developing and updating personalized prevention plans based on individual patient needs and physician guidance.
• Collaborating with the supervising physician to ensure accurate documentation and follow-up on any identified health concerns using electronic health record systems.
• Identifying any HCC codes requiring recapture reporting to CMS.
• Maintaining comprehensive and accurate patient records in compliance with HIPAA and organizational standards, particularly in a remote environment.
• Facilitating virtual referrals to appropriate healthcare services and specialists as needed.
• Monitoring patient progress and adherence to personalized prevention plans, providing support and making adjustments as necessary through telehealth follow-ups.
• Staying current on Medicare guidelines, telehealth best practices, preventive care practices, and chronic disease management strategies.
• Participating in virtual team meetings, training sessions, and continuing education to maintain and enhance clinical skills.

Qualifications
WHAT YOU'LL NEED FOR SUCCESS

• Must be fully bi-lingual in Korean and English languages.
• Must be located in GA.
• Current and unrestricted Registered Nurse (RN) license in the state of GA.
• Availability for PRN work Monday through Friday, 8:00am to 5:00pm, aproxametly 20 hours per week.
• Minimum of 3 years of patient care nursing experience, preferably in a primary care, preventive care, or telehealth setting.
• Experience with Medicare Annual Wellness Visits (AWVs) and telehealth platforms is highly desirable.
• Strong knowledge of Medicare guidelines, telehealth practices, and preventive care strategies preferred.
• Excellent interpersonal and communication skills, with the ability to educate and engage patients effectively in a virtual environment.
• Proficient in electronic health records (EHR) systems, telehealth technology, and remote medical documentation.
• Ability to work independently and manage time effectively in a remote work setting.
• Strong organizational skills and attention to detail.

Additional Information
The salary range for this role is $42/hour (PRN) plus language differential
ALIVE with Purpose: How We Thrive at Guidehealth
At Guidehealth, our values come to life in everything we do.

• We are Driven by Accountability - grounded in transparency, reliability, and integrity as we navigate challenges and opportunities alike.
• Always Growing, Always Learning - staying curious and continuously improving inspires us to shape a better future for healthcare.
• With Collaborative Innovation, we solve problems creatively, making every experience better for our employees and the patients we serve.
• At Guidehealth, Every Voice Matters - we believe our collective strength is rooted in the unique perspectives of each team member.
• And through Empathy in Action, we build stronger connections with those who count on us.
• This is what it means to be ALIVE with purpose. This is how we thrive - together - at Guidehealth.

BENEFITS:
While you are hard at work advancing value-based healthcare, we are here to ensure YOU have the care you and your family need and the opportunities for growth and development. Our commitments to you include:

• Work from Home: Guidehealth is a fully remote company, providing you the flexibility to spend less time commuting and more time focusing on your professional goals and personal needs.
• Keep Health a Priority: We offer comprehensive Medical, Dental, and Vision plans to keep you covered.
• Plan for the Future: Our 401(k) plan includes a 3% employer match to your 6% contribution.
• Have Peace of Mind: We provide Life and Disability insurance for those "just in case" moments. Additionally, we offer voluntary Life options to keep you and your loved ones protected.
• Feel Supported When You Need It Most: Our Employee Assistance Program (EAP) is here to help you through tough times.
• Take Time for Yourself: We offer paid time off plans helping you achieve work-life balance and meet your personal goals.
• Support Your New Family: Welcoming a new family member takes time and commitment. Guidehealth offers paid parental leave to give you the time you need.
• Learn and Grow: Your professional growth is important to us. Guidehealth offers various resources dedicated to your learning and development to advance your career with us.

All full-time employees of Guidehealth who work 30 hours per week or more are eligible for our comprehensive benefits package. Temporary employees and contractors are not eligible for benefits.
COMPENSATION:
The listed compensation range listed is paid bi-weekly per our standard payroll practices. Final base pay decisions are dependent upon a variety of factors which may include, but are not limited to: skill set, years of relevant experience, education, location, and licensure/certifications.
OUR COMMITMENT TO EQUAL OPPORTUNITY EMPLOYMENT
Diversity, inclusion, and belonging are at the core of Guidehealth's values. We are an equal opportunity employer. We enthusiastically accept our responsibility to make employment decisions without regard to race, religious creed, color, age, sex, sexual orientation and identity, national origin, citizenship, religion, marital status, familial status, physical, sensory, or medical disability, Family and Medical Leave, military or veteran status, pregnancy, childbirth or other related medical conditions, or any other classification protected by federal, state, and local laws and ordinances. Our management is fully dedicated to ensuring the fulfillment of this policy with respect to hiring, placement, promotion, transfer, demotion, layoff, termination, recruitment advertising, pay, and other forms of compensation, training, and general treatment during employment.
OUR COMITTMENT TO PROTECTION OF PATIENT AND COMPANY DATA
This position is responsible for following all Security policies and procedures in order to protect all PHI and PII under Guidehealth's custodianship as well as Guidehealth Intellectual Properties. For any security-specific roles, the responsibilities would be further defined by the hiring manager.
As a remote-first organization handling sensitive healthcare data, Guidehealth verifies candidate identity at multiple stages of the hiring and onboarding to safeguard patient privacy, data security, and compliance requirements.
REMOTE WORK TECHNICAL REQUIREMENTS
Guidehealth is a fully remote company. We provide new employees with the necessary equipment to function in their role at no charge to the employee. Employees provide their own internet connection, capable of conducting video calls on camera and connecting to various internal and external systems. The required internet speed is a minimum of 100 mbps download, 10 mbps upload. Please run a speed test here to confirm your internet connection meets these requirements.
SECONDARY EMPLOYMENT
At Guidehealth, we value transparency and collaboration as part of our commitment to excellence. As your primary employer, we kindly ask all team members to disclose any secondary employment, regardless of whether it may present a potential conflict of interest.
To ensure smooth teamwork and availability, employees must be accessible during our stated working hours. We foster connection and engagement by asking team members to join virtual meetings with their cameras on.