Utilization Review Nurse

Washington, DC
$41.38 p/hr
Feb 02, 2021
Feb 10, 2021
Full Time

This is a long term contract for Full Time DC Licensed RNs to handle patient Chart Review. Client is located in Washington, DC at a metro accessible location.

This is an 8:30am to 5:00pm, Monday through Friday... NO SHIFT WORK! NO WEEKENDS!

The Chart Review Nurse will conduct on-site chart audits reviews (Nursing Home review) to determine if the beneficiary meets DC Medicaid Level of Care guidelines. The audit also include establishing regulatory compliance. The RN will conduct MDS Review and electronic CMS data base. The RN is also required to complete Utilization Review - via Interqual (policy database) which requires experience in the acute hospital setting. There will be paid training done on-site (DC Office).

Goals: 1 nursing home site visit per day and 12 reviews completed per day.
Duties: Review Medicaid resident's charts (paper and/or electronic), Document chart review findings into medical management system, complete and close cases to initiate approval or denial correspondence.

Nurses will work in the DC office reviewing documents when not assigned to a facility that day.

**RN will conduct reviews and on-site nursing home reviews (in facilities, NOT HOMES)**

Job Requirements

Must Have:
• Active DC License required
• 2+ years of inpatient psychiatric experience A PLUS
• 2+ years of Utilization Review and/or Chart Review experience
• Bilingual Spanish/English a HUGE Plus but not required
• Must have valid Driver's License
• Clean Drug Screen and Background Check required
• Must have reliable transportation
• Proficient in MS Word, Excel, Outlook; Type 45wpm

Full Time Hours: Monday through Friday 8:30am to 5pm
Laptop provided
Must be actively licensed in DC
Compensation: $41.38 per hour
Office is a Metro accessible location
Parking reimbursed for facility visits ONLY

Please email resume to mrobinson@nri-staffing.com

Additional Information

NRI is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, among other things, or status as a qualified individual with disability.

Meet Your Recruiter

Marian Robinson
Senior Account Manager

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