Clinical Reviewer Nurse

Job Details IHCS provides an Integrated Delivery System in the home setting, which includes DME, Respiratory, Home Health and Home Infusion services. IHCS has a select network of Medicare and/or Medicaid Certified and Accredited providers to respond to the needs of our patients – 24/7. We operate with the sole intent of providing the highest quality in-home care services that improve and enhance the daily living for our patients. We are a trusted market leader with over 30 years of experience in Home Health, Durable Medical Equipment and Home Infusion Services. If you are passionate about inspiring, motivating, and leading teams, this opportunity could be for you. Benefits Full time team members competitive compensation package, include but not limited to: Medical, Vision, Dental, Short- and Long-term insurance 6+ Days of Holidays Pay PTO Employer paid life insurance 401K with employer contribution Wellness program with reward incentives Employee recognition and reward programs Comprehensive paid training program What Will You Be Doing As a Utilization Management Nurse, you will ensure that home health care services are administered with quality, cost efficiency, and within compliance. By continuously reviewing and auditing patient treatment files, the utilization nurse will ensure that patients won’t receive unnecessary procedures, ineffective treatment, or unnecessarily extensive home healthcare. Concurrent review of patient’s clinical information for efficiency Ongoing review of precertification requests for medical necessity Coordinates patient care needs with a multi-disciplinary healthcare team Maintain accurate records of all patient related interactions Ability to stay organized and interact well with others in any situation Provide updates to Manager of Utilization Management for review What Will You Bring State licensure as a LPN or RN Minimum 2 years of prior experience in Utilization Management Strong knowledge of word processing and spreadsheet computer programs Utilization Management or Case Management certification preferred Equal Opportunity Statement IHCS is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. #J-18808-Ljbffr Integrated Home Care Services, Inc.