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Utilization Review Nurse – Night Shift (12AM to 8AM ET/Fully Remote USA)

Remote – Other

Full time

R010232

Are you an RN with a passion to help improve the quality of patient care without working bedside? Do you have acute care experience within an emergency room, critical care, or med/surg setting? Do you have experience doing concurrent review, case management, or utilization management? Are you seeking an opportunity to work in your home on a team with other dedicated clinicians in an organization focused on achieving the best outcomes?

McBee Associates, a leader in clinical advisory services, is growing and adding to our remote team of Utilization Review Nurses focused on admissions and continued stay reviews. With the shift to value-based and patient-centered care, McBee has become the company health systems rely upon to ensure care management plans are effective and accurate. We take a partnership approach in care coordination with our clients that results in accurate patient status and reduced denials. Submit your application today and talk with us about the possibilities of working with McBee, a Netsmart company.

Responsibilities

As a remote associate working from home, it is important you have an office that provides the privacy needed for your critical work. Your reviews start at the point of admission, verifying that documentation meets medical necessity requirements utilizing hospitals’ approved evidence-based criteria, identifying missing and insufficient documentation. You will work with physicians on their plan of care and documentation to support the appropriateness of the level of care ordered. The work you do helps hospitals and health systems improve care efforts throughout their organization and increase their cash flow.

Qualifications

• Active RN licensure in your state of residency with at least 5 years’ clinical experience in an acute care setting in Emergency Department, Critical Care, or Medical/Surgical Care.
• At least 3 years’ experience in Case Management, Concurrent Review, or Utilization Management.
• Experience with InterQual and Milliman Clinical Guidelines (MCG).
• All shifts available. Associates are required to work two weekend shifts per month.

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Netsmart is proud to be an equal opportunity workplace and is an affirmative action employer, providing equal employment and advancement opportunities to all iniduals. We celebrate ersity and are committed to creating an inclusive environment for all associates. All employment decisions at Netsmart, including but not limited to recruiting, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. Netsmart does not discriminate in employment opportunities or practices based on race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate.

All applicants for employment must be legally authorized to work in the United States. Netsmart does not provide work visa sponsorship for this position.