Job Description

Job Description

Job Description

TO BE CONSIDERED FOR THIS ROLE YOU MUST RESIDE IN EST or CST TIME ZONES

• Monday through Friday
• 8:00 AM -5:00 PM with flexibility to work outside of business hours, as needed.
• Pay range between $28.00 to 31.00 per hour

Job Summary

The Quality or Care team reviews documentation and interprets data obtained from clinical records or systems to apply appropriate clinical criteria and policies in line with regulatory and accreditation requirements for member and/or provider issues. Condenses complex information into a clear and precise clinical picture while working independently. Reports clinical findings to appropriate staff or others in order to ensure appropriate outcome and/or follow-up for improvement as indicated. The incumbent must demonstrate strong clinical judgement as well as knowledge of internal systems.

Job Qualifications

• RN with current unrestricted compact license and willing to obtain additional licensure as needed.
• 3+ years of clinical experience required
• 2+ years’ experience using personal computer, keyboard navigation, navigating multiple systems and applications; and using MS Office Suite applications (Teams, Outlook, Word, Excel, etc.)

Preferred Qualifications

• Emergency/critical care experience
• Experience working Grievance cases
• Case Management or Utilization Management experience
• Managed care experience

Education

BSN degree preferred
Minimum of Associates or Diploma nursing degree required

For immediate consideration email Charisse with the job title and resume at cjohnson@anchorstaffing.com

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