Compact Licensed Utilization Management RN

Job Summary

Working remotely on a part-time basis, the Compact Licensed Utilization Management RN will manage telephonic clinical assessments, provide patient education services, and render initial determinations of medical appropriateness for health benefit plans during core office hours of 9am to 6pm ET, Monday through Friday.

Key responsibilities

• Perform telephonic clinical assessments and document calls accurately in the computer system
• Obtain and interpret clinical information to support recommendations for inpatient and outpatient services
• Answer calls related to medical services and determine prior authorization requirements

Required qualifications

• Active, unrestricted RN Compact License
• Minimum of 1 year experience in a hospital setting
• Minimum internet speeds of 25Mbps download and upload
• Proficiency with Microsoft Office Suite (Outlook, Word)
• Preferred: 1+ years previous Utilization Management experience