Advize is a data-driven company that specializes in auditing and analyzing healthcare data to identify waste, fraud, and abuse. With a focus on building relationships with providers based on data and best practices, Advize leverages Big-4 Data Analytics and OIG best practices to uncover instances of fraud in the healthcare industry.
Role Description
This is a full-time remote role for a Utilization Review Nurse.
Must have utilization/management/case management experience and InterQual proficiency.
You will be responsible for reviewing and analyzing medical records, verifying charges, and ensuring that medical services align with established guidelines and policies. They will collaborate with healthcare personnel and patients, conduct audits, and deliver audit results to clients.
Qualifications
Utilization Management and Discharge Planning skills
Knowledge of Medicine and Nursing
Experience working with Medical Records
Strong analytical and problem-solving skills
Excellent written and verbal communication skills
Attention to detail and ability to work independently
Ability to maintain confidentiality and adhere to ethical standards
Experience in conducting audits or reviews is a plus
Bachelor's degree in Nursing or a related field is preferred
Employment type
Full-time
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