What are the responsibilities and job description for the Utilization Review Nurse - WFH- Resident of Indiana position at Syra Health Corp.?
Applicants must have Utilization Review Experience and must be a resident of INDIANA Position Summary:This role involves managing a case load with a focus on medical necessity reviews, clinical requests, and effective case management. If you have a keen eye for detail, excellent clinical judgment, and enjoy working in a dynamic, virtual environment, we’d love to hear from you.Key ResponsibilitiesManage a census of 35-45 cases, aiming to address 25 cases per day. Responsibilities include medical necessity reviews, handling clinical requests, managing discharges, and making case management referrals.Participate in bi-weekly rounds with physicians and the case management team to coordinate patient care effectively. Qualifications:Candidate must have acute care, ICU, and Med/Surg experience in an inpatient hospital (bedside care) setting.Required experience in Utilization Management and/or familiarity with Milliman Care Guidelines.Required experience in acute inpatient (hospital) nursing, demonstrating strong clinical knowledge and decision-making skills.Comfortable working in a virtual setting with proficiency in IT/computer applications, including Excel, Microsoft Outlook, and Microsoft Teams.Quick learner with the ability to adapt to frequent process changes.Consistent and excellent attendance record.Valid Indiana RN license or compact license is essential.Company DescriptionSyra Health is a healthcare consulting company with a mission to improve healthcare by providing innovative services and technology solutions. Syra Health aims to achieve its goal by becoming a valuable partner to government, payers, providers, life sciences organizations, and academic institutions. Syra Health offers products and services in digital health, behavioural and mental health, population health management, health education, and healthcare workforce.
Salary : $72,000 - $73,000