TITLE: Clinical Reviewer (RN) AIMS & IDR, NY Medicaid
LOCATION: Remote (must live in New York, do not apply if outside of NY)
REQUIRED EDUCATION/EXPERIENCE:
GENERAL RESPONSIBILITIES:
These candidates will be cross trained to work with the IDR team and the AIMS Clinical Review team. The AIMS team deals with NY Medicaid.
This individual will complete the full spectrum of activities related to State and Federal Independent Dispute Resolution (IDR) case determinations. They will conduct clinical level review, Prior Authorization, and disputed benefits review, supporting Medical Review Analysts, and Physician Consultants to ensure an appropriate and accurate process.
DUTIES:
QUALIFICATIONS:
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