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Registered Nurse / Cost Outlier Auditor / Med-Surg Nurses Preferred / TRAINING PROVIDED

RN Nurse Auditor (Cost Outlier Auditor) – Permanent, Full-Time Role, Starting Salary of $80,000 with Excellent Benefits!

Training Provided:  If you are a Med/Surg Nurse and want to be trained in medical management - Please Apply!!!

Working Conditions: Full time (M-F) Office in Downtown, Manhattan

Position Summary: This role will be responsible for Cost Outliers and Special Projects

Job Responsibilities:

  • Ability to complete all aspects of cost outlier work independently
  • Maintain and update training materials as needed
  • Maintain and update all hospital profiles as needed
  • Assist with the training and orientation of all new staff
  • Communicates with external liaisons on issues specific to projects and with account representatives specific to program process
  • Perform QA of  reviewers as assigned
  • Perform various reviews such as Cost Outliers, Day Outliers, Pre and Post payment Utilization review, Quality Reviews , and review of outpatient claims
  • Assists the Operations department with data abstraction for special studies
  • Works closely with the Vice President of Review Operations to insure the completion of all assignments

Requirements:

  • BSN or equivalent preferred
  • 2-5 years Utilization Review experience and/or Managed Care experience
  • 2 years of Hospital experience required

Qualifications:

  • Ability to prioritize and organize workload to insure that all assignments are completed timely
  • Detail oriented highly organized work skills
  • Ability to communicate effectively both orally and in writing
  • Excellent computer skills
  • Commitment to continuously provide quality services to all customers
  • Ability to train new staff to the process
  • Attends committee meetings as assigned

Registered Nurse / Cost Outlier Auditor / Med-Surg Nurses Preferred / TRAINING PROVIDED

New York, NY 10018
Full Time
Early Career (2+ yrs experience)

Published on 07/25/2019