Nurse Reviewer (Registered Nurse) - Remote in US
Gainwell Technologies LLCAlabama, United States • Bossier City, Louisiana, United States • North Carolina, United States • Arkansas, United States • North Dakota, United States • Oklahoma, United States • Montana, United States • Kentucky, United States • Mississippi, United States • Idaho, United States • Texas, United States
Posted May 1, 2025
65000 - 75000 USD year
About the Company
Gainwell Technologies empowers healthcare innovation through digitally-enabled services for Medicaid and related programs.
Job Description
We are seeking a talented individual for a Nurse Reviewer (RN) who will be responsible for performing clinical reviews to determine if the medical record documentation supports the need for the service based on clinical criteria, coverage policies, and utilization and practice guidelines.
Requirements
- 5+ years clinical experience in an inpatient hospital setting
- 2+ years utilization review experience or claims auditing
- Experience using Milliman or InterQual criteria
Benefits
- Health benefits (medical, dental, vision)
- Paid time off benefits
- Company provided computer
- Monday through Friday work schedule
- Flexible vacation policy
- 401(k) employer match
- Comprehensive health benefits
- Educational assistance
- Leadership and technical development academies
