[Remote] DME Medical Reviewer

Note: The job is a remote job and is open to candidates in USA. Broadway Ventures is a Service-Disabled Veteran-Owned Small Business that specializes in program management and consulting solutions. They are seeking a DME Medical Reviewer to provide medical claims review services by registered nurses, ensuring compliance with licensing and performance measures. Responsibilities • Subcontractor will provide medical claims review services by registered nurses • At a minimum, nurses shall hold active, unrestricted RN license from the United States and in the state of hire OR Active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) • CGS Administrators will perform periodic license checks during the period of performance • Subcontractor will ensure employees working from home are in compliance with Contractor’s work at home requirements • By the 15th of the following month, Subcontractor will submit a monthly summary report to the Contractor program managers. At a minimum, the report should cover: Summary of staffing by all positions. This would include how many staff are working on the subcontract, how many positions are being recruited and a summary of recruiting efforts, upcoming changes to staffing levels, Brief financial update including current subcontract spend compared to total amount on subcontract, any updates to planned spend rate, and other financial information that has the potential to impact subcontract, Any necessary updates specific to staff that would help Contractor plan for the coming weeks / months. This could include extended vacation for staff, changes to pay rates, planned termination dates, etc • On a quarterly basis, Subcontractor leadership will schedule and conduct a “state of the state” meeting with the Contractor Program Managers, Medical Review leadership team, and Contractor’s small business liaison to discuss how current efforts are going and if any changes need to occur to ensure long term goal are achieved • All Subcontractor staff will be required to meet the same criteria as Contractor staff in the same role. Criteria generally include: Monthly quality audits, Monthly productivity goals, Adherence to accepted schedule, Adherence to Contractor’s standard operating procedures, Adherence to Contractor’s code of conduct Skills • Active, unrestricted RN license from the United States and in the state of hire OR Active compact multistate unrestricted RN license as defined by the Nurse Licensure Compact (NLC) • Associate degree – Nursing; Graduate of an accredited School of Nursing • 2 years clinical experience • Compliance with Contractor’s work at home requirements Company Overview • We deliver expert program management, cutting-edge IT, cybersecurity, and consulting solutions for government and commercial clients. It was founded in 2013, and is headquartered in Amite, Louisiana, USA, with a workforce of 51-200 employees. Its website is Apply tot his job