Remote Clinical Review Utilization Management Registered Nurse

Job is Expired
Location: Nationwide
Compensation: To Be Discussed
Staff Reviewed: Tue, Nov 29, 2022

Job Summary

A independent, not-for-profit health benefits organization needs applicants for an opening for a Remote Clinical Review Utilization Management Registered Nurse.

Candidates will be responsible for the following:

  • Assisting non-clinical staff in performance of administrative reviews
  • Initiating referrals to ensure appropriate coordination of care
  • Seeking the advice of the Medical Director when appropriate, according to policy

Skills and Requirements Include:

  • 3 years - Clinical experience required
  • Registered Nurse (RN) with active license in the state of Tennessee or hold a license in the state of their residence
  • Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
  • Working knowledge of URAC, NCQA and CMS accreditations
  • Excellent oral and written communication skills
  • Strong interpersonal and organizational skills

COMPLETE JOB DESCRIPTION

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