What are the responsibilities and job description for the Registered Nurse - Clinical Review - REMOTE position at Actalent?
Job title – Registered Nurse – Clinical Review
Job Description –
- Reviewing member complaints from a clinical standpoint
- Liaising with coordinators and providers on the team to request for pertinent medical records.
- Synthesizing material and performing an accurate interpretation / case summary of medical records
- Managing a queue of cases and ensuring due dates are achieved.
- Liaising with medical directors regarding clinical case reviews
- Participating in Peer Review and Rounding Meetings
- Liaising with the Lead RN and Manager of the department for day-to-day processes
Employee Value Proposition
- Fully remote role with an opportunity to go on direct with client
Schedule – Monday through Friday (day shift) (6 months duration)
Additional Skills & Qualifications:
- Can NOT hire from CT, DC, HI, NM, OH, PA, SD, TN, and WV - must have California RN license
- Must be in California to go directly with Blue Shield of California.
Diversity, Equity & Inclusion
At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:
- Hiring diverse talent
- Maintaining an inclusive environment through persistent self-reflection
- Building a culture of care, engagement, and recognition with clear outcomes
- Ensuring growth opportunities for our people
Actalent is an equal opportunity employer.
About Actalent
Actalent connects passion with purpose. We help visionary companies advance their engineering and science initiatives through access to specialized experts that drive scale, innovation, and speed to market. With a network of almost 30,000 engineering and sciences consultants and more than 4,500 clients across the U.S., Canada, Asia, and Europe, Actalent serves many of the Fortune 500. An operating company of Allegis Group, the global leader in talent solutions, Actalent launched as a new specialized engineering and sciences services and workforce solutions brand in 2021.
Salary : $50 - $55
