About the role

Are you ready for your next career adventure?! Integrated Management Strategies (IMS) is an award-winning, fast-growing woman-owned small business in the Washington DC area, specializing in healthcare, technology, and management consulting. We are seeking an experienced Sr Review Coordinator to join our healthcare consulting practice. The role is fully remote within the US. We are proud of our national presence, and excited to offer great career opportunities within the organization. 

What you'll do

• Perform utilization review/medical management including prospective, concurrent, and retrospective review for Long Term Care and Hospice services.
• Review the complex plans of service and act as a resource for non-clinical reviewers.
• Act as a resource for non-clinical reviewers.
• Provide independent review decisions for behavioral health services and the appropriateness of quality of care based on contract, state or URAC requirements.
• Screen situations according to specific criteria to determine if care is appropriate.
• Refer cases that fail to meet criteria to peer reviewers.
• Ensure review is conducted thoroughly and within specified timeframes.
• Serve as liaison among peer reviewers, providers, facilities, and/or subscribers.
• Document medical information supporting decisions into the workflow documentation system, ensuring data is entered accurately and timely.

Required Qualifications

• Compact RN License in Maryland
• 3 – 5 years of recent experience working in a clinical environment
• Long Term Care experience
• Good written and oral communication skills
• Typing and data entry skills, familiarity with computer systems, and use of multiple monitor work systems
• Because of the nature and immediacy of the work, the ability to maintain regular and predictable attendance is essential

Preferred Qualifications

• Knowledge of medical coding and billing
• Hospice experience

What we offer:

In addition to a rewarding career, IMS offers a wide range of benefits to its employees, including:

• 401(k) Retirement Plan
• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time
• 11 Company Paid Holidays
• Medical & Dependent Care Flexible Spending Accounts
• Group Life & Accidental Death & Dismemberment (AD&D) Insurance
• Group Short Term Disability Insurance
• Voluntary Life Insurance, Long Term Disability Insurance, Accident Insurance, Critical Illness Insurance, and Hospital Indemnity Insurance
• Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Position may be eligible for a discretionary variable incentive bonus

Integrated Management Strategies is an equal opportunity employer that is committed to diversity and inclusion in the workplace. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, gender identity, national origin, disability, pregnancy, status as a protected veteran, or any other protected characteristic as outlined by federal, state, or local laws. If you are an individual with a disability and would like to request a reasonable accommodation for the employment process, please email your request to hr@im-strat.com

E-Verify® is a registered trademark of the U.S. Department of Homeland Security. This business uses E-Verify in its hiring practices to achieve a lawful workforce. www.dhs.gov/E-Verify

The salary range provided for this position is a nationwide market range and represents a broad range of salaries for this role across the country. The actual salary rate for this position will be determined by a number of factors, including, scope, complexity, and location of the role; the skills, education, training, credentials, and experience of the candidate, and other conditions of employment.