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CLINICAL REVIEW NURSE RN

Lewiston, ME
Change Healthcare
Posted 04/10/2021

Job Description:

Transforming the future of healthcare isn't something we take lightly. It takes teams of the best and the brightest, working together to make an impact. As one of the largest healthcare technology companies in the U.S., we are a catalyst to accelerate the journey toward improved lives and healthier communities.Here at Change Healthcare, we're using our influence to drive positive changes across the industry, and we want motivated and passionate people like you to help us continue to bring new and innovative ideas to life. If you're ready to embrace your passion and do what you love with a company that's committed to supporting your future, then you belong at Change Healthcare. Pursue purpose. Champion innovation. Earn trust. Be agile. Include all. Empower Your Future. Make a Difference. Clinical Review Nurse RN Overview of Position Clinical Team Review Nurse RN is responsible for systematic reviews, analysis and case review to determine support needs, approve additional support, medical add-on and increased staffing for members for the Section 21 Home and Community Based Waiver for Adults with Intellectual & Developmental Disabilities & Autism. What will be my duties and responsibilities in this job? * Perform systematic reviews, analyses, and case reviews to determine support needs, approve additional support, medical add-on and increased staffing for members * Perform timely case reviews and clinical input and recommendations about staffing and support needs * Facilitate case reviews, presentations, and team review meetings * Perform data collection and analysis within the system * Demonstrate excellent written documentation and record keeping skills * Interact professionally with various levels of leadership and teams within OADS. What are the requirements needed for this position? * Current Registered Nurse license * Bachelor's degree or Master's degree in a health or emergency medical services program * Excellent written documentation and record keeping What other skills/experience would be helpful to have? * DDNA Certification for work with IDD/ASD populations What are the working conditions and physical requirements of this job? * General office demands Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system! Equal Opportunity/Affirmative Action Statement Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at and the supplemental information at If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to applyaccommodations@changehealthcare.com with "Applicant requesting reasonable accommodation" as the subject. Resumes or CVs submitted to this email box will not be accepted. Click here English_formattedESQA508c.pdf to view our pay transparency nondiscrimination policy. Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.

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