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USRN - Utilization Review (RN )

Location
Philippines
Job Type
Permanent
Posted
12 Sep 2022
Clinical Manager/Admin opening in Pasig City, Metro Manila.

Vivo HealthStaff is looking for Remote USRN for US Health Plans. USRNs review medical cases to ensure that quality medical care is being performed.

Responsibilities:

  • Addresses the following issues: compliance, level of care, length of stay, and hospital reimbursement for our hospital clients.
  • Review and respond to the customer in a timely manner; usually within 1-2 hours of the submission to the queue.
  • Must work during pre-scheduled hours to be highly successful in this role (schedules are created 30 days in advance).
  • USRN should be highly capable of working independently with a high level of performance in in a rapidly changing, fast paced environment.
  • Successful physician will need to meet productivity standards.
  • Actively engage with attending physicians to discuss appropriate status as supported by documentation.
  • Make phone contact with utilization review team and/or case managers at client hospitals regarding submitted case determinations.
  • Provide written analysis of the case and perform case reviews across multiple specialties

Required Qualifications:

  • Active, unrestricted USRN license. Preferably in a Compact License State
  • Strong clinical knowledge base across multiple areas
  • Must be computer proficient
  • Strong verbal and written communication skills
  • Must be professional, organized and possess persuasive writing and speaking skills
  • Possess strong negotiating/reasoning/logic and problem-solving skills
  • Must have some flexibility with schedule (minimum of 20/hours week)
  • Weekend work commitment required
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Details

  • Job Reference: 710359093-2
  • Date Posted: 12 September 2022
  • Recruiter: Vivo HealthStaff Inc.
  • Location: Philippines
  • Salary: On Application
  • Sector: Healthcare & Medical
  • Job Type: Permanent