Colorado Licensed Utilization Management Nurse

Job Summary

A company is looking for a Utilization Management Nurse RN - Remote in MST Hours.

Key Responsibilities:

• Conduct prior authorization reviews for skilled nursing facilities, acute inpatient rehabilitation, and long-term acute care hospitals
• Evaluate medical appropriateness of levels of care based on medical guidelines and benefit determinations
• Provide resources and explanations on complex issues while identifying solutions to non-standard requests

Required Qualifications:

• Active, unrestrictive RN license in state of residency or Compact RN License
• 3+ years of Managed Care and/or Clinical experience
• Proven basic computer skills with MS Outlook, Word, and Excel
• Weekend availability
• Must work in Mountain Standard Time Zone