Req'd Experience: 3 years
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For over 43 years has been a mainstay here in NYC as a leading medical review organization. Their mission has been to provide health care assessment services that assist clients in improving the appropriateness, quality and cost effectiveness of health care. This organization has an outstanding reputation for medical reviews in programs for prospective , concurrent and retrospective monitoring. They continue to build successful and meaningful partnerships with labor organizations, corporations, insurance companies and managed care groups.
Today we are hiring a Cost Outlier RN Auditor to join are review team. This role is ideal for either someone with previous utilization review, or auditing work or for an experienced Medical Surgical registered nurse who is looking to step away from bedside to come to work in our office in the city.
Features and Benefits
• Monday – Friday 8:00 AM -5:00PM No Weekends No On call
• Great Salary : $80,000.00
• Comprehensive Health Care Benefits
• Great PTO Plan
• Working with a dedicated and knowledgeable team.
• Ability to leave bedside and work in a professional office environment.
• Many others.
The Role You Will Play
• Maintain and update training materials as needed
• Maintain and update all hospital profiles as needed.
• Communicates with external liaisons on issues specific to projects and with account reps specific to program process.
• Perform QA 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 operation department with data abstraction for special studies .
• Works closely with the VP of Review Operations to insure the completion of all assignments.
Ideal Background Profile
BSN or Equivalent Required.
3+ years recent nursing experience in a medical surgical or ICU unit.
1+ years’ experience in Utilization Review or Managed Care preferred but not required.
For more info and to apply: please contact : Kelly Moore, Manager of Recruitment- Direct Hire
MSG Staffing, Inc. / 508.799.7674 ext 118 / firstname.lastname@example.org