Remote Licensed Utilization Review Nurse

Location: Nationwide

Compensation: Hourly

Staff Reviewed: Tue, Oct 12, 2021

This job expires in: 16 days

Job Category: Healthcare

Remote Level: 100% Remote

Weekly Hours: Full Time

Employer Type: Employer

Career Level: Experienced

Job Summary

An IT business services company needs applicants for an opening for a Remote Licensed Utilization Review Nurse.

Core Responsibilities Include:

  • Evaluating clinical information submitted by providers against plan review criteria and benefit guidelines
  • Documenting all pertinent case information and dispositions for approvals and denials
  • Utilizing clinical information to determine if criteria for medical necessity and benefit guidelines are met

Position Requirements Include:

  • At least 2 years of clinical experience in a hospital, acute care, direct care or utilization management
  • Preferred: 2+ years of UM/CM experience; One of the following certifications: MCG, ACM, CCM, CMC, and/or CMCN

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