Remote Prior Authorization Utilization Management Registered Nurse

Job is Expired

Location: Texas

Compensation: To Be Discussed

Staff Reviewed: Wed, Sep 15, 2021

Job Category: Healthcare

Remote Level: 100% Remote

Weekly Hours: Full Time

Employer Type: Employer

Career Level: Experienced

Job Summary

A global healthcare company is seeking a Remote Prior Authorization Utilization Management Registered Nurse.

Core Responsibilities Include:

  • Performing utilization review activities, including pre-certification, concurrent, and retrospective reviews according to guidelines
  • Conducting rate negotiation with non-network providers, utilizing appropriate reimbursement methodologies
  • Documenting rate negotiation accurately for proper claims adjudication

Qualifications Include:

  • Current, unrestricted Texas RN license or compact license
  • 2+ years of experience in managed care OR 5+ years nursing experience
  • Proficient in PC Software computer skills
  • Telephonic and/or telecommute experience
  • Excellent communication skills both verbal and written skills
  • Prior Authorization experience

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