Florida Licensed Utilization Management RN

Job Summary

A company is looking for a LTSS Utilization Management RN - Remote.

Key Responsibilities

• Perform utilization management and determine medical necessity for in-home LTC services
• Provide critical analysis of case manager UM submissions and prepare documentation for Medical Director review
• Act as a resource for others, coaching and guiding less experienced staff

Required Qualifications

• Unrestricted RN license in state of residence
• 1+ years of managed care and/or clinical experience, preferably in Medicaid and Utilization Management
• 1+ years of Medicaid Utilization Management experience
• 1+ years of experience with Microsoft Office (Word, Excel, PowerPoint)
• 1+ years of experience navigating in a Windows environment