Job Summary
A professional services firm is filling a position for a Remote Compact License Managed Care Utilization Management Nurse.
Core Responsibilities Include:
- Determining appropriateness of services through the application and evaluation of medical guidelines, benefit determinations and compliance with state mandated regulations
- Performing 15-30 reviews per day
- Performing initial and concurrent review of inpatient admissions
Must meet the following requirements for consideration:
- 2+ years of utilization management experience
- Current unencumbered RN license
- 5+ years of acute clinical experience
- Strong knowledge of utilization management processes and industry best practice