WNS Global Services
Nurse - Clinical Review
Houston, NA, United States
Sponsorship not specifiedDetected 23 days ago
Agentic AIComplianceExcelLogisticsCustomer SupportHIPAACommunicationCollaborationCritical ThinkingTime ManagementMicrosoft Office
About the role
- This represents the base pay range that we reasonably expect to offer for this position.
- WNS complies with all applicable federal, state, and local pay transparency laws, including those in California, Colorado, New York, Washington, and Illinois.
- Equal Opportunity Employer Statement WNS is an Equal Opportunity Employer.
Responsibilities
- We bring together deep domain excellence - WNS' core differentiator - with AI-powered platforms and analytics to help businesses innovate, scale, adapt and build resilience in a world defined by disruption.
- Performs clinical reviews according to the policies and procedures of HealthHelp within the identified State and Federal or Client agreed upon timeframes.
- Collaborates with client personnel to resolve customer concerns.
- Maintains written documentation according to HealthHelp's documentation policy.
- Creates, encourages, and supports an environment that fosters teamwork, respect, diversity, and cooperation with others.
- Effectively utilizes various computer systems and software to manage cases and document reviews.
- Performs other related duties and projects as assigned to meet business needs.
Requirements
- Participates in the HealthHelp Quality Management Program, as required.
Compensation
- This represents the base pay range that we reasonably expect to offer for this position.
Benefits
- Performs utilization review of cases to determine if the request meets medical necessity criteria in accordance with medical policies agreed upon with the Client and any applicable governing body.
- Assists Physician Reviewers and Medical Directors, as necessary, to ensure compliance with review timeframes.
- Promotes business focus which demonstrates an understanding of the company's vision, mission, and strategy.
Equal opportunity
- Employer Statement
- WNS is an Equal Opportunity Employer.
- We celebrate diversity and are committed to creating an inclusive environment for all employees.
- All qualified applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity or expression, national origin, age, disability, genetic information, veteran status, or any other status protected under federal, state, or local law.
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This listing is sourced directly from WNS Global Services's careers page and normalized into a canonical job model.