Post Review Nurse – Health Services

Use Your Strengths as a Post Review Nurse! About the opportunity: As a Post Review Nurse, you will utilize clinical knowledge and expertise to interpret and appropriately apply medical policy, InterQual criteria, and benefit information to post-service claims in a production-based environment with timeframe and quality metrics. In addition, you will provide consultation to utilization management requests and claims inquiries. As part of a multidisciplinary team, you will collaborate with internal teams to continuously look for ways to improve processes and maximize health dollars for our members.  About you: You are passionate about making healthcare better and enjoy a role where you can be both collaborative but also work independently to make an impact. You thrive in a fast-paced work environment where your time management, prioritization, and multi-tasking skills are critical to success. You see yourself as being resourceful and adaptable. Technology savviness, such as experience in utilizing and troubleshooting Microsoft Office products (Outlook, Excel, Teams, etc), is a must.   Candidates located in Iowa or South Dakota preferred. This role is remote eligible and will require candidates to provide high-speed internet at their work location.