Job Title: USRN Clinical Trainer

Shift: Night shift

Work Set-up: On-site

Salary Range: 60K to 90K, depending on candidate's qualifications

Start Date: ASAP

Recruitment Process: 2 Virtual interviews

QUALIFICATIONS:

• Bachelor’s Degree in Nursing with a current and valid USRN license


• Minimum of 2 years of experience in utilization management, including medical necessity approvals and denials


• Experience in virtual or classroom training


• At least 1 year of experience with the InterQual process


• 1 to 2 years of experience in a training role


• BPO/CPO experience preferred


• Experience in a healthcare or clinical environment


• Familiarity with Medicare rules and regulations, including coverage criteria and coding principles


• Experience in handling appeals, utilization review, or related healthcare management functions


• Excellent verbal and written communication skills for preparing appeal arguments


• Ability to analyze complex medical information and identify relevant clinical issues


• Willingness to work on-site with flexible schedules, including night shifts and holidays


• Must not have been previously employed by the company

PRE-SCREENING QUESTIONS:

1. Do you have an active USRN license?


2. How many years of experience do you have in utilization management and medical necessity approvals and denials in a healthcare or BPO/CPO environment?


3. How many years of experience do you have as a trainer?


4. Please share your experience with the InterQual process.


5. Are you familiar with Medicare rules and regulations, including coverage criteria and coding principles?


6. On a scale of 1 to 10, how would you rate your ability to analyze complex medical information and identify relevant clinical issues (10 being the highest)?


7. What was your last drawn salary?


8. What are your salary expectations?


9. Are you willing to work on-site with a night shift and fixed weekends off?


10. When would you be available to start if hired?