Clinical Reviewer- Diagnostic Imaging Nurse HealthHelp, Inc.

Job Responsibilities:

Conducts clinical review of cases that do not meet criteria
Performs clinical intake and reviews cases according to the policies and procedures of HH
Collects and enters confidential information ensuring the highest level of confidentiality in all areas
Refers cases to a Physician Reviewer or the Director of Utilization Management per guidelines
Maintains written documentation according to HHs documentation policy
Provides ongoing telephonic education to providers and office staff related to HHs Clinical Review process
Assists in the orientation and training of new Clinical Reviewers in department procedures, protocols, and administrative tasks when requested
Assists Director of Utilization Management with execution of QI projects
Participates and understands scope of responsibility in all ongoing QI Projects

Job Qualifications:

RN, LPN/ LVN graduate from an accredited school of nursing or radiation therapy
Current, active RN, LPN/LVN license
2 years previous UM/QM experience in a managed care or 3919863acute hospital setting
Computer proficiency required
Good organizational skills preferred
2-3 years experience in acute care environment.

Location:	Houston, TX United States