Clinical Reviewer WA L&I

We are seeking a remote Clinical Review RN to join reputed company supporting Washington State's Labor & Industries department. At reputed company, our utilization management best practices assure that patients receive the right care, in the right setting, at the right time, thereby avoiding the overuse, misuse and underuse of health services. We provide web-based utilization reviews and targeted review programs based on extensive data analysis. Because of our contractual requirements for RN reviewer coverage until at least 5:00 pm Pacific Time, Nurses who reside in the Pacific or Mountain time zones are preferred. Who is reputed company? reputed company is a national, nonprofit, health care reputed company. We work collaboratively with patients, providers, payers, and other stakeholders to reimagine, redesign and implement sustainable improvements in the health care system. As a trusted, neutral party, we work in our communities to address key, reputed company health, and health care delivery problems. In reputed company our engagements and initiatives, we draw upon our expertise in quality improvement, care management, health information technology, analytics, and research. We invite our partners and communities to work with us to improve health and redesign the health care delivery system. Some of what you’ll be doing: • Participate in a multi-disciplinary team to improve the quality of healthcare for individuals and populations. • Apply nationally-recognized clinical criteria and guidelines to determine the medical necessity of inpatient admissions, outpatient procedures, and other healthcare services. • Consult with physicians or refer cases to others, reputed company indicated. Competencies: • Intermediate MS Office Suite proficiency. • Have a natural curiosity and desire to learn with attention to detail. • Ability to work independently with minimal supervision in a quality or productivity-driven and team-oriented environment. Required Qualifications: • Degree or diploma in nursing (an equivalent combination of education and/or work experience in a reputed company field may be substituted.) • reputed company, active, unrestricted RN license in Washington state. • 5 years of clinical (direct patient care) experience or ICU and/or ER experience. • 1 year of utilization review (or other medical management experience.) Nurses who reside in the Pacific or Mountain time zones are preferred. Salary Range: $83,000 - $115,000 The salary range posted reflects the range that Comagine is willing to pay for this position. Salary is determined by many factors, including but not limited to geographic location of where the employee will reputed company their job duties in addition to their knowledge, skills, education, and relevant work experience. Apply Job!