Clinical Advisor at nTech Workforce

Pay Rate: $40/hr on W2

Must-Have:

• Must have a Laptop/computer with internet to work from home.
• Active Registered Nurse (RN) license in Maryland or a Multi-State Compact license.

Terms of Employment

• W2 Contract, Three Months (Seasonal / Part-Time)

• This position is 100% remote.

• The selected individual will work 15-25 hours per week. They can have another position and work off hours and/or weekends. With that said, the selected individual must be comfortable meeting with the team during normal work hours for up to an hour for status updates.

Overview & Responsibilities

Work with a leading healthcare organization as a Clinical Advisor providing critical support during the busy utilization review season. This is an internal, non-patient-facing role focused on clinical "detective work." You will analyze high-cost claimant data to help the clinical team understand medical trends and claims drivers. This role offers incredible flexibility, allowing you to complete much of your work during evenings or weekends, provided deadlines are met. You will…

• Research high-cost claimants by navigating through three to four different clinical and pharmacy systems.

• Retrieve and interpret clinical notes, pharmacy data, and medical management records to "tell the story" of a member's care.

• Identify what is driving claims expenses, such as inpatient stays, specialty drugs (gene therapy/biosimilars), or multiple surgeries.

• Populate data into Excel and prepare information for clinical presentations and slide decks.

• Collaborate with internal nurses and Medical Directors to review findings and receive guidance on clinical notes.

Required Qualifications

• Active Registered Nurse (RN) license in Maryland or a Multi-State Compact license.

• Minimum of 4-5 years of clinical nursing experience.

• Strong clinical "generalist" knowledge to understand various medical conditions (Critical Care background highly preferred).

• Proficiency in Microsoft Office, particularly Excel (data entry/manipulation) and Word.

• Ability to work independently and manage time effectively to meet a 1.5-week turnaround for client investigations.

• Availability for a mandatory Monday morning orientation (9 AM – 11 AM EST) and intermittent daytime training during the first two weeks.

Preferred Qualifications

• Experience in Utilization Review, Care Management, or Healthcare Data Analysis.

• Familiarity with platforms like HealthEdge, Guiding Care, or pharmacy databases (e.g., Artnetrix).

• Experience with PowerPoint for creating internal presentations.