Qureos Mentor

Medix™

<div>
 
 
 Job Title:
 
 Clinical Reviewer (RN)
 
 
 
 Reports To:
 
 Director / Assistant Director
 
 
 
 Position Overview:
 
 
 
 We are seeking a detail-oriented and experienced
 
 Registered Nurse
 
 to join our team as a Clinical Reviewer. This role is responsible for conducting comprehensive reviews related to State and Federal Independent Dispute Resolution (IDR) cases, prior authorizations, and disputed benefits. The Clinical Reviewer will support Medical Review Analysts and Physician Consultants to ensure accurate, timely, and compliant determinations.
 
 
 
 Key Responsibilities:
 
 
 <ul>
 <li>
 Conduct clinical reviews up to the appeal level, including chart screening, regulatory guidance compilation, insurer research, electronic worksheet completion, and preparation of final determinations.
 </li>
 <li>
 Serve as a resource to administrative and clinical staff by providing training, problem-solving support, and clarification of determinations.
 </li>
 <li>
 Mentor and train new RNs as projects expand.
 </li>
 <li>
 Assess and adjudicate claims, collaborating with cross-functional teams as needed.
 </li>
 <li>
 Participate in collaborative trainings and other activities to support team objectives.
 </li>
 </ul>
 
 
 Qualifications:
 
 
 <ul>
 <li>
 Licensed
 
 Registered Nurse (RN) in New York State
 
 required.
 </li>
 <li>
 Must reside in
 
 New York State
 
 .
 </li>
 <li>
 Bachelor&rsquo;s degree in Nursing or completion of an approved Registered Nurse training program required.
 </li>
 <li>
 Minimum of two years of clinical experience required.
 </li>
 <li>
 Proficiency with electronic medical records.
 </li>
 <li>
 Strong written and verbal communication skills.
 </li>
 <li>
 Ability to work independently, meet deadlines, and collaborate effectively with peers, medical staff, and administrative teams.
 </li>
 <li>
 Flexible, innovative, and able to adapt to a fast-paced, time-sensitive environment.
 </li>
 </ul>
 
 
 Why Join Us:
 
 
 
 This is an excellent opportunity for a motivated RN in New York to apply clinical expertise in a dynamic and collaborative environment while contributing to fair and accurate case determinations.
 
</div>

REMOTE Review Nurse (NY License) - 248365

<div>
 
 
 Associate Physician &ndash; Allergy &amp; Asthma
 
 
 
 📍
 
 Northern Colorado / Ft. Collins Area
 
 
 
 🕒
 
 Full-Time | 4-Day Work Week
 
 
 
 A large, established, and highly respected
 
 multi-site allergy &amp; asthma practice
 
 is seeking a dedicated
 
 Associate Physician
 
 to join its growing team in the Northern Colorado/Ft. Collins region. This single-specialty group is known for delivering exceptional, personalized care in a warm, collaborative, and patient-centered environment.
 
 
 With
 
 11 Board-Certified Allergists
 
 ,
 
 15 Advanced Practice Providers
 
 , and a team of
 
 155 support staff
 
 serving over
 
 56,000 patients
 
 across
 
 9 Front Range locations
 
 , this practice offers an outstanding opportunity to build a meaningful and rewarding career in allergy, asthma, and immunology.
 
 
 
 Responsibilities
 
 
 
 As an Associate Physician, you will:
 
 <ul>
 <li>
 Provide high-level specialty care for patients with upper and lower respiratory tract conditions, cutaneous and gastrointestinal disorders, and a wide range of hypersensitivity conditions.
 </li>
 <li>
 Perform evaluations and diagnostic procedures including:
 </li>
 <li>
 Immediate and delayed hypersensitivity skin testing
 </li>
 <li>
 Pulmonary function testing (including bronchoprovocation)
 </li>
 <li>
 Rhino-laryngoscopy
 </li>
 <li>
 Radiographic evaluation
 </li>
 <li>
 Additional specialty-specific assessment techniques
 </li>
 <li>
 Deliver care to both adult and pediatric populations in a supportive, team-based clinical setting.
 </li>
 <li>
 Contribute to an active, compassionate, and patient-focused practice culture.
 </li>
 </ul>
 
 
 Benefits &amp; Highlights
 
 
 <ul>
 <li>
 
 4-Day Work Week
 
 promoting strong work-life balance
 </li>
 <li>
 
 Competitive compensation with production/incentive-based bonuses
 
 </li>
 <li>
 
 Comprehensive insurance and benefits package
 
 </li>
 <li>
 Work alongside an experienced, professional, and collegial team
 </li>
 <li>
 Opportunity to serve a diverse and growing patient population within a thriving regional practice
 </li>
 </ul>
 
 
</div>

Associate Doctor-248335

Join Medix™ and explore 2   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Medix™

ABOUT_COMPANY

REMOTE Review Nurse (NY License) - 248365

Associate Doctor-248335