Clinical Medical Review Nurse at Ampcus: 100% Remote (Owings Mills, MD)
Title: Clinical Medical Review Nurse
Location: Owings Mills, MD
Job Description:
Job Description
Ampcus Inc. is a certified global provider of a broad range of Technology and Business consulting services. We are in search of a highly motivated candidate to join our talented Team.
Job Title: Clinical Medical Review Nurse.
Location: Owings Mills, MD.
Summary:
- The Contingent RN supports CareFirst by analyzing high‐cost claimant and population health data to support utilization review, ad‐hoc requests, and client reports.
- This position requires experience excising and understanding medical terminology, analytical expertise, and cross‐team collaboration in a fast‐paced, data‐driven environment. This is an internal, non–client‐facing role. The timeframe for this position will fluctuate depending on need.
Key Responsibilities:
- Retrieve and interpret clinical, financial, and population health data across multiple systems.
- Identify trends, gaps in care, and opportunities for improved health outcomes.
- Provide clinical expertise and translate complex data into clear insights for internal stakeholders.
- Support cost‐containment and quality‐improvement initiatives through data‐driven recommendations.
- Communicate effectively across teams and levels, including leadership.
- Work independently with minimal supervision while maintaining accuracy and meeting deadlines.
Additional Skills:
- RN, data analytics, excel, understanding of clinical terminology, cause and effect rationale (inquisitive).
Qualifications:
- Registered Nurse (RN) – active state or compact license.
- 4 years’ clinical experience plus 2 years of healthcare data analysis.
- Proficiency in Excel, Word, PowerPoint; strong analytical and critical‐thinking skills.
- Ability to influence and collaborate with stakeholders across the organization.
- Bachelor’s degree required (or 4 years’ equivalent experience).
- Preferred: Graduate degree (MSN, MBA, MPH) and experience within a health plan or business‐focused role.
Role Characteristics:
- Individual contributor who researches high‐cost claimants, populates slide decks, and responds to ad‐hoc requests.
- Resolves moderately complex problems using established processes and clinical judgment.
- Frequent cross‐department communication.
- Represents the team with professionalism and a collaborative mindset.
- Remote work environment with minimal physical demands.
