About Us

Absolute Staffing & Consulting Solutions is a woman, minority, and veteran-owned business based in Westminster, Maryland. As a trusted subcontractor, we specialize in staff augmentation for IT, allied health, customer support, administrative roles, and more, serving private businesses and government entities at all levels.

Job Title: Senior Review Coordinator

Location: Remote

Job Type: Part-Time (Six-Month Engagement)

Pay Rate: $40.00- $42.00 / hour depending on experience

General Summary:

The Senior Review Coordinator will be responsible for conducting utilization review/medical management for all services, including training/mentoring other team members, and performing preliminary research on requested topics. In addition, you may provide technical assistance, medical record review, and support to provider staff and physician reviewers.

Essential Functions:

• You will perform prospective, concurrent, and continued stay utilization review/medical management for Long-Term Care and Home & Community-Based Services
• You will review for appropriateness of care based on contract, state, or URAC requirements
• You will screen individual situations according to specific criteria to determine if care is appropriate
• You will refer cases that fail to meet screening criteria to peer reviewer
• You will coordinate and participate in peer-to-peer review as warranted
• With prior management approval, you may deviate from criteria with proper justification to authorize the service
• You will serve as liaison between peer reviewer, provider, facility and/or subscriber
• You will coordinate and participate in appeal process as directed by management
• You will train or serve as a mentor to team members and physician reviewers to ensure reviews and appeals are conducted thoroughly and within specified time frames
• You will perform preliminary research on topics such as experimental or cosmetic services, coverage determinations, coding or standards of care
• You will document review and special project results in workflow documentation system, ensuring data is accurate and timely
• You will assist in compliance reporting
• You will perform miscellaneous duties as assigned

Required Skills and Experience:

• Four-year degree in health care or two or three-year degree in nursing or related field and/or equivalent training and/or experience
• 3+ years of recent experience working in a clinical environment
• Current Maryland state RN license
• Because of the nature and immediacy of the work, the ability to maintain regular and predictable attendance is essential.
• We are unable to consider candidates outside of the United States, candidates in the state of California, or those in US Minor outlying islands and territories

Preferred Skills:

• Prior UM experience
• Strong Oral/Written Communication
• Professional Image
• Attention to Detail
• Teamwork Skills
• Technical Expertise
• Good Judgment
• Relationship Building & Influencing

Working Conditions:

• Remote, WFH
• Monday – Friday 9:00-5:00 EST. No weekends or holidays.

Pay Rate: $ 40.00- $42.00 / hour depending on experience