Job Summary
A professional services firm has a current position open for a Remote Concurrent Review Nurse in Edison.
Candidates will be responsible for the following:
- Identifying solutions to problems and non-standard requests
- Conducting UM review and discharge planning at the facility level
- Following and maintaining compliance with regulatory agency requirements
Skills and Requirements Include:
- Current unencumbered RN license
- Familiarity with Milliman and InterQual guidelines
- Knowledge of current standard of medical practices and insurance benefit structures
- Strong knowledge of case-management processes
- Detailed knowledge and competency in all types of medical-necessity decisions
- Strong nursing expertise in managing patients
