Contract RN Medical Reviewer II Palmetto GBA-id-9105

by

๐Ÿฉบ Contract RN Medical Reviewer II (Work from Home After Training)

๐Ÿ“ Location: Columbia, SC or Birmingham, AL (Remote after on-site training)
๐Ÿ•’ Schedule: Monday โ€“ Friday | 8:00 AM โ€“ 5:00 PM
๐Ÿ“… Training Start Date: October 28, 2024 (No time off permitted during the 6-week training period)
๐Ÿ’ผ Employer: Palmetto GBA โ€“ RCD Medicare Medical Review Team

About the Opportunity

Are you a Registered Nurse looking to move from bedside to administrative work in a mission-driven organization? Join Palmetto GBA as a Contract RN Medical Reviewer II and play a critical role in improving the accuracy and quality of Medicare claim reviews under the Review Choice Demonstration (RCD) program.

This position is ideal for experienced RNs who are ready to transition into a remote, non-clinical role while still making a meaningful impact in patient care through medical review. No patient interaction is required.

What Youโ€™ll Do

As an RN Medical Reviewer, you will:

What You Need to Qualify

  • Active RN license in the state of hire or a Compact Multistate RN license (as defined by the Nurse Licensure Compact)

  • Associate Degree in Nursing or graduate of an accredited nursing program

  • Minimum 2 years of clinical nursing experience

  • Proficiency in Microsoft Office (Word, Excel, Outlook)

  • Strong judgment, analytical thinking, and organizational skills

  • Ability to work independently in a fast-paced, detail-oriented role

  • Excellent verbal and written communication skills

  • Must have high-speed internet and a private, HIPAA-compliant home office

Preferred Qualifications (Nice-to-Haves)

  • Experience in medical review or utilization review

  • 5+ years of varied RN experience (Emergency, ICU, or Med/Surg preferred)

  • Familiarity with Medicare guidelines and CMS documentation requirements

  • Proficiency with Windows-based software and multi-system navigation

Training Requirements

  • Start Date: October 28, 2024

  • Location: On-site in Columbia, SC or Birmingham, AL

  • Duration: 6 weeks (no time off allowed during this period)

  • After successful training, the position becomes fully remote.

โœ… Employee Benefits

  • 401(k) retirement savings plan with company match

  • Comprehensive health insurance with free vision coverage

  • Life insurance coverage

  • Paid annual leave (accrues with tenure)

  • 9 paid holidays

  • Access to on-site fitness centers and cafeterias (training locations)

  • Wellness programs and lifestyle incentives

  • Tuition assistance for continued education

  • Employee recognition and service award programs

Why Palmetto GBA?

Palmetto GBA is a trusted leader in Medicare program administration. When you join our team, youโ€™re not just reviewing claimsโ€”youโ€™re helping improve care quality, reduce fraud and waste, and support the Medicare community.

๐Ÿš€ Apply Now

Ready to take your nursing career in a new directionโ€”without leaving your clinical judgment behind? Apply now to join a team thatโ€™s committed to quality, integrity, and innovation in healthcare.

๐Ÿ”— Learn more about this opportunity and apply today at: palmettogba.com/careers

Contract RN Medical Reviewer II Palmetto GBA-id-9105

Leave a Comment

×

Download PDF