Job Summary
A leading global professional services firm is filling a position for a Remote Concurrent Review Nurse in Los Angeles.
Core Responsibilities of this position include:
- Assessing members' needs
- Identifying solutions to problems and non-standard requests
- Maintaining compliance with regulatory agency requirements
Skills and Requirements Include:
- Current unencumbered California RN license
- 2+ years of acute hospital clinical experience
- 4+ years of utilization management experience
- In-depth knowledge of medical practices standards and benefit structures
- Competency in all types of medical-necessity decisions
- Familiarity with Milliman and InterQual guidelines
