Clinical Reviewer Nurse, CWOCN

Job Summary

IHCS provides an Integrated Delivery System in the home setting, including DME, Respiratory, Home Health, and Home Infusion services. We have a network of certified and accredited providers available 24/7 to meet patient needs. Founded in 1990, we are the market leader in Home Health, Durable Medical Equipment, and Home Infusion Services. We are seeking a Utilization Management Nurse, CWOCN who can inspire, motivate, and lead teams.

Responsibilities

• Ensure home health care services are administered with quality, cost efficiency, and compliance
• Review and audit patient treatment files to prevent unnecessary procedures, ineffective treatment, or excessive home healthcare
• Coordinate patient care needs with a multi-disciplinary healthcare team
• Maintain accurate records of all patient-related interactions
• Provide updates to the Manager of Utilization Management for review

Qualifications

• At least 2–3 years of wound, ostomy, or continence experience; CWOCN certification
• Concurrent review of patient's clinical information for efficiency
• Ongoing review of precertification requests for medical necessity
• Ability to stay organized and interact well with others in any situation

Requirements

• State licensure as a LPN or RN
• CWOCN Certification required
• Minimum 2 years of prior experience in Utilization Management
• Strong knowledge of word processing and spreadsheet computer programs
• Utilization Management or Case Management certification preferred

Benefits

• Competitive compensation package including medical, vision, dental, short- and long-term insurance
• 6+ days of holidays
• Paid time off
• Employer-paid life insurance
• 401K with employer contribution
• Wellness program with reward incentives
• Employee recognition and reward programs
• Comprehensive paid training program

Company Information

IHCS is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.