Sr Review Coordinator

Integrated Management Strategies, LLC

1d•Remote

About The Position

Are you ready for your next career adventure?! Integrated Management Strategies (IMS) is an award-winning, fast-growing woman-owned small business in the Washington DC area, specializing in healthcare, technology, and management consulting. We are seeking an experienced Sr Review Coordinator to join our healthcare consulting practice. The role is fully remote within the US. We are proud of our national presence, and excited to offer great career opportunities within the organization.

Requirements

Compact RN License in Maryland
3 – 5 years of recent experience working in a clinical environment
Long Term Care experience
Good written and oral communication skills
Typing and data entry skills, familiarity with computer systems, and use of multiple monitor work systems
Because of the nature and immediacy of the work, the ability to maintain regular and predictable attendance is essential

Nice To Haves

Knowledge of medical coding and billing
Hospice experience

Responsibilities

Perform utilization review/medical management including prospective, concurrent, and retrospective review for Long Term Care and Hospice services.
Review the complex plans of service and act as a resource for non-clinical reviewers.
Act as a resource for non-clinical reviewers.
Provide independent review decisions for behavioral health services and the appropriateness of quality of care based on contract, state or URAC requirements.
Screen situations according to specific criteria to determine if care is appropriate.
Refer cases that fail to meet criteria to peer reviewers.
Ensure review is conducted thoroughly and within specified timeframes.
Serve as liaison among peer reviewers, providers, facilities, and/or subscribers.
Document medical information supporting decisions into the workflow documentation system, ensuring data is entered accurately and timely.

Benefits

401(k) Retirement Plan
Medical, Rx, Dental & Vision Insurance
Personal and Family Sick Time
11 Company Paid Holidays
Medical & Dependent Care Flexible Spending Accounts
Group Life & Accidental Death & Dismemberment (AD&D) Insurance
Group Short Term Disability Insurance
Voluntary Life Insurance, Long Term Disability Insurance, Accident Insurance, Critical Illness Insurance, and Hospital Indemnity Insurance
Personal Development & Learning Opportunities
Skills Development & Certifications
Employee Referral Program
Corporate Sponsored Events & Community Outreach
Position may be eligible for a discretionary variable incentive bonus