Oregon and Washington Licensed Utilization Review RN

Job Summary

A company is looking for a Utilization Review RN - Remote.

Key Responsibilities

• Administer medical management programs, including prior authorization and concurrent reviews
• Conduct retrospective reviews of claims and data for care coordination and discharge planning
• Develop medical policies and manage appeals and grievances

Required Qualifications

• 5 years of clinical nursing experience
• Oregon and Washington State Registered Nurse Licenses upon hire
• Experience collaborating with physicians in patient care management