What are the responsibilities and job description for the Nurse Consultant position at APremium Healthcare Solution, LLC?
Benefits:
Key Responsibilities
Required
- 401(k) matching
- Competitive salary
- Dental insurance
- Home office stipend
Key Responsibilities
- Review clinical documentation, medical records, and patient data for accuracy, quality, and compliance.
- Provide expert clinical guidance to internal teams, clients, or external partners.
- Support case management, utilization review, care coordination, or quality improvement initiatives (customizable).
- Conduct assessments, triage, and nurse consultations via phone or virtual platforms.
- Analyze trends in patient care, outcomes, and service delivery to recommend improvements.
- Prepare clinical summaries, reports, and recommendations based on findings.
- Collaborate with physicians, allied health professionals, and administrative staff.
- Ensure adherence to clinical guidelines, regulatory standards, and organizational policies.
- Participate in training, audits, and process improvement initiatives.
- Maintain strict confidentiality and comply with HIPAA and other privacy regulations.
Required
- Active, unrestricted RN license (state-specific or compact license, as required).
- Minimum 3 years of clinical nursing experience (acute care, telehealth, case management, or specialty).
- Strong understanding of clinical best practices, evidence-based guidelines, and healthcare regulations.
- Excellent critical thinking, communication, and documentation skills.
- Comfortable working independently in a remote environment with strong time-management and organizational abilities.
- Proficiency with electronic health records (EHRs), telehealth platforms, and standard office software.
- Bachelor of Science in Nursing (BSN) or higher.
- Experience in utilization review, quality improvement, risk management, insurance, or legal nurse consulting.
- Certification in relevant specialties (e.g., CCM, CPHQ, LNC, URAC certifications).
- Knowledge of reimbursement models, coding concepts, and managed care processes.
- Clinical expertise and sound judgment
- Strong analytical and documentation skills
- Effective written and verbal communication
- Professionalism and patient-centered focus
- Ability to collaborate across multidisciplinary teams
- Adaptability and problem-solving in remote settings
- 100% remote work environment
- Competitive salary and benefits package
- Flexible scheduling options
- Opportunities for professional growth and specialty certifications
- Supportive team culture and strong clinical leadership
- Work-life balance with meaningful impact on patient care and organizational outcomes