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Registered Nurse Sr. Consultant

Job Attributes

Job Id:

23828

Job Category:

Clinical & Life Sciences

Job Location:

Owings Mills, MD  21117

Security Clearance:

No Clearance

Business Unit:

Piper Companies

JOB DESCRIPTION

Piper Clinical Solutions is in search of a driven Registered Nurse Sr. Consultant in Owings Mills, MD to support a local healthcare service provider.

 

Responsibilities for the Registered Nurse Sr. Consultant:

 

  • Provide utilization review and coordination to a hospital facility for inpatient services which will vary per assignment
  • Ensure patients receive necessary, appropriate, and adequate care based on review of related medical information
  • Responsible for concurrent reviews including admission, continued stay, and short stay claims and ensure accurate and appropriate clinical documentation
  • Holds weekly meetings with associated facility Medical Directors
  • Work hand in hand with Physicians, Care Coordinators, and other members of the staff daily
  • National travel up to 25%
  • Serves as Clinical SME for Finance team
  • Responsible for audits of insurers and plans to ensure comprehensive program compliance

 

Requirements for the Registered Nurse Sr. Consultant:

 

  • 3+ years acute care nursing required
  • Case Management, Utilization Management/Review, Appeals experience required
  • MCO Experience preferred
  • Knowledge of Milliman and InterQual
  • BSN (Bachelor's in Science, Nursing) and RN required

 

Compensation for the Registered Nurse Sr. Consultant:

 

  • Salary up to $95,000 based on qualification of skills
  • Benefits include Health/Dental/Vision coverage, PTO, 401K

 

Please send all qualified resumes to: dmanley@pipercompanies.com

 

 

Keywords:

Inpatient, utilization review, RN, UR, registered nurse, acute care, medical, healthcare, concurrent review, health insurance, nurse, Advantage MD, USFHP, case manager, CCM, Medicare, Medicaid, post-pay, tri-care, MCO, continued stay, short stay, discharge, utilization, hospital, BSN, nurse, InterQual, Milliman, claims, cases, patients, electronic health record

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Job Id:

23828

Job Category:

Clinical & Life Sciences

Job Location:

Owings Mills, MD  21117

Security Clearance:

No Clearance

Business Unit:

Piper Companies