Senior Inpatient UM Nurse Auditor

September 27

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Cohere Health

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201 - 500

Description

• Audit acute inpatient authorizations for unplanned admissions. • Synthesize patterns across audits. • Help build presentations for audit results. • Collaborate with teams for automation algorithms. • Evaluate performance of automation algorithms.

Requirements

• Registered Nurse (RN), associate or bachelor’s degree. • 10+ years of experience in payer utilization management. • Understanding of acute inpatient authorization processes. • Independent, objective thinker. • Extremely diligent with a focus on quality. • Adept at analyzing data. • Values simplicity in complex concepts. • Understanding of AI / ML in UM optimization. • Inclination to improve the status quo. • Proficient in clinical review apps and spreadsheets.

Benefits

• Equal Opportunity Employer. • Fostering an environment of mutual respect. • Commitment to diversity and inclusivity.