Remote Concurrent Review Registered Nurse in Cherry Hill

Job ID: Available for Members

Location: New Jersey

Compensation: To Be Discussed

Staff Reviewed: Mon, Nov 12, 2018

Job Category: Case Management, Healthcare, Nursing

Telecommute Level: Majority

Travel Requirements: Possible Travel

Weekly Hours: Full Time

Employer Type: Employer

Career Level: Experienced

Education Level: Some College

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