Job Summary

A management consulting provider is in need of a Remote Concurrent Review Registered Nurse in Cherry Hill.

Must be able to:

• Identify solutions to problems and non-standard requests
• Determine medical appropriateness of inpatient and outpatient services
• Ensure proper utilization of health services by assessing the member's needs and identifying solutions

Required Skills:

• Demonstrated nursing knowledge and competency in all types of medical-necessity decisions
• Strong knowledge of case-management processes, standards, and an understanding of managed care
• Minimum of 2+ years of acute clinical experience and 4+ years of utilization management experience
• Current unencumbered RN license for the state and any other compact states
• In-depth knowledge of current standard of medical practices and insurance benefit structures
• Familiarity with Milliman and InterQual guidelines