Job Summary
A healthcare company has a current position open for a Remote Utilization Management Nurse.
Core Responsibilities of this position include:
- Reviewing conducted after services have been provided to the patient
- Applying clinical expertise and judgment to ensure compliance with medical policy
- Consulting with physician advisors to ensure clinically appropriate determinations
Applicants must meet the following qualifications:
- Knowledge of health insurance industry trends, technology and contractual arrangements
- General computer skills
- Strong verbal, written and interpersonal communication and customer service skills
- Ability to interpret policies and procedures and communicate complex topics effectively
- Strong organizational and time management skills with the ability to manage workload independently
- Ability to think critically and make decisions within individual role and responsibility
