[Hiring] Consultant-Nurse @Integrated Resources

Role Description

• Responsible for reviewing favorable and partially favorable determinations in accordance with applicable regulations.
• Render medical necessity determinations for Medicare State East cases assigned.
• Resolve all other technical issues within Medicare reconsideration assigned.
• Review cases to determine and summarize facts of each case assigned and assess issues involved in the case.
• Perform other special projects not related to a specific case such as general legal research, general medical research, drafting proposal sections, or acting as a liaison for a specific project, when necessary.
• Perform other duties as assigned by management.

Qualifications

• Bachelor's degree with 3-5 years of experience consulting within designated function.
• REGISTERED NURSE

Company Description