Overview
Remote
Depends on Experience
Contract - W2
Job Details
Care Review Processor | 2 years’ experience | Remote | Nevada | Contract
Walker Healthforce is seeking a Care Review Processor with 2 years of experience to support a healthcare client based out of Nevada. This is a 3-month contract opportunity.
START DATE: 11/1/2025
WORKER TYPE: W2
CORE REQUIREMENTS:
JOB RESPONSIBILITIES:
WHAT WE OFFER:
WHY WORK WITH WALKER?
Contact our Recruiting Team today to experience the Walker Healthforce difference!
ABOUT US:
Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we’re custom not commodity and we’ve been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today!
We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status.
#IND2
Walker Healthforce is seeking a Care Review Processor with 2 years of experience to support a healthcare client based out of Nevada. This is a 3-month contract opportunity.
START DATE: 11/1/2025
WORKER TYPE: W2
CORE REQUIREMENTS:
- Minimum of 2 years of clinical practice
- Experience with NCQA.
- In depth knowledge of Interqual and other references for length of stay and medical necessity determinations.
- Demonstrated ability to communicate, solve problems, and work effectively with people.
- Excellent organizational skill with the ability to manage multiple priorities.
- Work independently and handle multiple projects simultaneously.
- Knowledge of applicable state, and federal regulations.
- Ability to take initiative and see tasks to completion.
- Computer Literate (Microsoft Office Products).
- Excellent verbal and written communication skills.
- Ability to maintain attendance to support required quality and quantity of work.
- Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
- Skilled at establishing and maintaining positive and effective work relationships with coworkers, clients, members, providers and customers.
- Completion of an accredited Registered Nursing program. (a combination of experience and education will be considered in lieu of Registered Nursing degree)
- Active, unrestricted Nevada State Nursing (RN, LVN, LPN) license in good standing
JOB RESPONSIBILITIES:
- Complete and maintain a daily productivity rate of 15 authorizations a day for concurrent review or 20 authorizations a day for prior authorization
- Provides concurrent review and prior authorizations (as needed) according to policy for members as part of the Utilization Management team.
- Identifies appropriate benefits, eligibility, and expected length of stay for members requesting treatments and/or procedures.
- Participates in interdepartmental integration and collaboration to enhance the continuity of care for members including Behavioral Health and Long-Term Care.
- Maintains department productivity and quality measures.
- Attend regular staff meetings.
- Assists with mentoring of new team members.
- Completes assigned work plan objectives and projects on a timely basis.
- Maintain professional relationships with provider community and internal and external customers.
- Always conducts self in a professional manner.
- Maintains cooperative and effective workplace relationships and adheres to company Code of Conduct.
- Consults with and refer cases to medical directors regularly, as necessary.
- Comply with required workplace safety standards.
WHAT WE OFFER:
- Competitive compensation package
- Weekly pay via Direct Deposit
- Medical, Dental & Vision available
- 401k options
WHY WORK WITH WALKER?
- Access to our top ranked team of recruiting and placement specialists
- Continuous, one-on-one support from a dedicated engagement manager
- Professional resume development and interview preparation
Contact our Recruiting Team today to experience the Walker Healthforce difference!
ABOUT US:
Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we’re custom not commodity and we’ve been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today!
We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status.
#IND2
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