RN Nurse Auditor (Cost Outlier)
at RCM Health Care Services

Date Posted: 3/8/2019

Job Description

RN Nurse Auditor (Cost Outlier Auditor) – Permanent, Full-Time role, Salary up to $80,000 with Excellent Benefits!!
 
Training Provided:  If you are a Med/Surg Nurse and want to be trained in medical management - Please Apply!!!
Working Conditions: Full time (M-F) Office in Downtown, Manhattan
 
Position Summary: This role will be responsible for Cost Outliers and Special Projects
Job Responsibilities:
  • Ability to complete all aspects of cost outlier work independently
  • Maintain and update training materials as needed
  • Maintain and update all hospital profiles as needed
  • Assist with the training and orientation of all new staff
  • Communicates with external liaisons on issues specific to projects and with account representatives specific to program process
  • Perform QA of  reviewers as assigned
  • Perform various reviews such as Cost Outliers, Day Outliers, Pre and Post payment Utilization review, Quality Reviews , and review of outpatient claims
  • Assists the Operations department with data abstraction for special studies
  • Works closely with the Vice President of Review Operations to insure the completion of all assignments
Requirements:
  • BSN or equivalent preferred
  • 2-5 years Utilization Review experience and/or Managed Care experience
  • 2 years of Hospital experience required
Qualifications:
  • Ability to prioritize and organize workload to insure that all assignments are completed timely
  • Detail oriented highly organized work skills
  • Ability to communicate effectively both orally and in writing
  • Excellent computer skills
  • Commitment to continuously provide quality services to all customers
  • Ability to train new staff to the process
  • Attends committee meetings as assigned
Salary up to $80,000 with Excellent Benefits!!

Job Snapshot

About Us

RCM Health Care Services offers career defining opportunities to candidates from the leading employers in health care. Whether you’re looking for a new job or seeking to hire the best medical talent, RCM Health Care Services has the solution for you. Since 1975, we’ve established ourselves as a leader in the recruitment industry by connecting thousands of healthcare professionals with placements that support their needs. If you’re looking to make the next move in your career, let RCM be your guide, we’re with you every step of the way!

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