Registered Nurse Utilization Management
Job Summary
Working remotely in a full-time capacity, the Registered Nurse Utilization Management will manage complex reviews and processing of authorization requests for various medical services, ensuring compliance with regulatory standards while maintaining high-quality outcomes.
Key responsibilities
- Independently conduct prospective, retrospective, and concurrent reviews for inpatient admissions and outpatient procedures
- Collaborate with management to ensure accuracy in documentation and compliance with Federal, State, and Regulatory requirements
- Facilitate safe discharge planning by coordinating with Health Partners, Care Managers, and Discharge Planners
Required qualifications
- Bachelor of Science in Nursing or Master's Degree in Social Work, Counseling, or a related field
- 3+ years of work experience in a related job discipline
- Current, unrestricted Registered Nurse (RN), Social Work, or Clinical Counselor Licensure in state(s) of practice
Complete Job Description
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