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Peer Review Coordinator

Health Care | San Francisco, CA | Full Time

Job Description

PEER REVIEW COORDINATOR

InGenesis is seeking a PEER REVIEW COORDINATOR for our client in downtown San Francisco, CA.   The client is a consulting firm that is seeking an RN with Managed Care or Peer Review experience.  


This is a full time or part time schedule and day time hours.  This is a contract long term position that is on-site, in office, with generous benefits and career growth options.


What you get to do:

  • LEVERAGE your nursing knowledge in a business capacity to review and processing requests for Independent Reviews from External Agencies.
  • WOW them with your attention to detail as you perform case review utilizing InterQual criteria and clinical knowledge for medical necessity and quality of care issues.   
  • Formulate and create case summary, review questions for the Physician Reviewer and other support documents
  • Communicate with contractors, providers and beneficiary/representatives for needed information (phone and email)


Qualifications


  • Excellent communication and strong writing skills
  • Ability to synthesize, analyze, large amounts of data and prepare summary documents on findings
  • Proficient in the use of standard EHR applications, office technology and MSOffice
  • Ability to handle sensitive and confidential information.


Minimum Education & Experience


  • Licensed Registered Nurse (RN) in CA, required.
  • Recent experience in utilization and quality reviews, required
  • Experience in managed care, quality management and peer review, preferred
  • Experience in the application of InterQual criteria, preferred.



BENEFITS:

 We aim to provide employees the tools they need to succeed as individuals and as employees. For this reason, we offer a competitive salary, health insurance, and other perks.  Apply Now!


HOW TO APPLY:

Click on the “Apply to this job” or contact the recruiter, Jane Navis at 262-345-5000.

We support a diverse workforce and is an Equal Opportunity Employer who does not discriminate against employees and applicants for employment on the basis of race, gender, color, religion, national origin, age, sexual orientation, gender identity, genetic information, disability, veteran status, or other classification protected by law.