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Job Title: UM/UR Nurse Reviewer - RN/LPN|
|Job Number (if applicable):
HB - 011|
|Location: Harrisburg, Pennsylvania |
Clinically driven. Client focused. Value based.
KePRO is a rapidly growing national quality improvement and care management organization. We work to ensure that over 4 million people receive the right care, at the right time, in the right setting. KePRO is currently seeking for our Harrisburg, PA location, a highly professional
UR/UM Nurse Reviewer - RN
Reviews and interprets patient records and compares against criteria to determine medical necessity and appropriateness of care; determines if the plan of care is followed in a timely manner and that the medical record documentation supports the delivery of quality care. Determines approval or referral to the physician consultant and processes physician consultant decisions. Abstracts review related data/information accurately and timely on appropriate review tool by the appropriate means. Ensures accurate and timely submission of all administrative and review related documents to appropriate parties. Maintains production goals and QA standards.
PA RN license required. 2 years of recent clinical nursing required; Inpatient, Med/Surg strongly desired. 1 – 2 yrs experience in URUM, Case Management or QA. Good verbal and written communication skills essential. Strong critical thinking skills necessary. Ability to work in a team environment. Flexibility and good organizational skills needed. Basic computer skills (copy/cut, paste, maneuvering screens and typing) necessary.
To Apply For This Position:
KePRO offers challenging careers, excellent benefits and opportunities for advancement. Come grow with a progressive health care management leader. To apply please submit resume and cover letter with salary requirements. Only those candidates identified for an interview will be contacted. No Phone Calls Please. Visit our main website at www.kepro.com for more information on the KePRO Family of Companies. KePRO is an Equal Opportunity Employer.
|Visit Our Website: https://home.eease.com/recruit/?id=904071|
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