Position Title: Clinical Review Nurse - Concurrent Review
Work Location: Remote – Any US State
Assignment Duration: 12 months
Work Arrangement: Fri-Sat-Sun-Mon 8:30 am CST - 6 pm CST

Responsibilities:
Working within a highly engaged team remotely, with ongoing support to produce denial correspondence based off the advisor review that is in easy-to-understand language to the member and adheres to the NCQA and state standards. There may be at times, OT expectations based on business needs. This team does work holidays, which are rotated amongst the team members
 

Candidate Requirements
Education/Certification	Required: Requires graduated from an accredited school of nursing or A.D. or bachelor’s in nursing			Preferred: 2-4 years of related experience
Licensure	Required: LPN or RN, active in any state			Preferred: Compact
Years of experience required:   Must haves: Minimum 1 year nursing experience. Live anywhere in the U.S.   Nice to haves: Knowledge of Medicare and Medicaid regulations; Knowledge of utilization management   Disqualifiers:   Performance indicators: Metric driven in production and quality
Top 3 must-have hard skills stack-ranked by importance		1	Ability to critically think
		2	Ability to effectively use Microsoft OneNote and Word
		3	Ability to work remotely, i.e. meet production deadlines; quality metrics
Candidate Review & Selection
Shortlisting process Candidate review & selection Interview information Onboard process and expectations		Projected Manager Candidate Review Date:			1-2 days post shortlisting
		Type of Interviews:			1 teams meeting interview
		Required Testing or Assessment (by Vendor):			NO

  
 
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws.This position's pay range is $32.00/hr - $37.00/hr.