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