Job Summary
A non-profit health care system has a current position open for a Remote RN Utilization Management Care Reviewer in Phoenix.
Candidates will be responsible for the following:
- Assessing inpatient services for members to ensure optimum outcomes, cost effectiveness, and compliance with all state and federal regulations and guidelines
- Analyzing clinical services from members or providers against evidence-based guidelines
- Identifying appropriate benefits, eligibility, and expected length of stay for requested services, treatments, and/or procedures.
Must meet the following requirements for consideration:
- Bachelor’s degree in nursing or equivalent working knowledge
- Active, unrestricted State Registered Nursing (RN) license in good standing
- Five years of clinical nursing experience. Utilization Management experience or equivalent working knowledge
