Bring your clinical expertise to a role that combines medical review, compliance, and problem-solving. Support the World Trade Center Health Program while working from home and making a direct impact on claims accuracy and member care.
About Broadway Ventures
Broadway Ventures is an 8(a), HUBZone, and Service-Disabled Veteran-Owned Small Business (SDVOSB) that delivers program management, technology, and consulting solutions to government and private sector clients. Guided by integrity and collaboration, Broadway Ventures transforms challenges into opportunities with innovation and excellence.
Schedule
- Remote within the US (preference for HUBZone residents)
- Monday–Friday, 8:00 AM – 4:30 PM EST
- Must have high-speed internet and a private home office
- Occasional travel to Augusta, GA (approx. 4 times per year)
What You’ll Do
- Conduct medical reviews for pre-pay and post-pay claims across specialties such as radiology, ambulance, physical therapy, and surgical
- Determine medical necessity, appropriateness, and coding accuracy using clinical guidelines
- Document rationale for approvals or denials and provide education to staff on medical review processes
- Participate in audits, quality control activities, and process improvement initiatives
- Support and mentor team members, including LPN staff
What You Need
- Active, unrestricted RN license (compact multistate preferred)
- Bachelor’s degree in Nursing (Master’s preferred)
- 5+ years of clinical RN experience plus 2+ years in utilization review, quality assurance, or home health
- Strong knowledge of managed care, clinical guidelines, and healthcare delivery systems
- Proficiency with Microsoft Office and ability to work independently
Benefits
- Salary: $67,700 annually
- 401(k) with employer match
- Comprehensive health, dental, and vision insurance
- Life insurance and disability coverage
- Flexible Spending Account (FSA)
- Paid time off and holidays
- Remote work flexibility
Put your RN expertise to work in a mission-driven program where accuracy and integrity matter.
Take the next step in your clinical career with Broadway Ventures.
Happy Hunting,
~Two Chicks…