A Reputable Nurse Review Company withing the Montgomery County, Maryland Area is currently seeking Referral Management Nurse/Reviewer to assist with a Government client need. They are seeking a Nurse Reviewer to assist in the case managment and crednetialling processes invovled within their organizaition. Click to apply!
• Provide Referral Management (RM) activities such as a timely review of Right of First Refusal (ROFR) requests, screening of specialty care referrals, sustaining up- to- date Specialty Clinic Referral and Booking Guidance, comply with Referral and Authorization Business rules, tracking and resulting in referrals, and full use of RM information management systems and
• Comply with Referral and Authorization Business rules, tracking and resulting of referrals, and full use of RM information management systems
• Conduct reviews for capacity and capability, and right of first refusal activities
• Reviews referrals for administrative, clinical completeness and appropriateness. Validates requested medical service, and authorizes surgery/medical procedures, laboratory, radiology, pharmacy, and general hospital procedures and regulations. Collaborates with DHA Regional Office Clinical Liaison Nurse and MTF Liaison to address any process issues or concerns.
- Years of experience: 5 years
- Experience level:Experienced
Working hours: 8 AM - 4 PM
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