Remote Utilization Management RN Care Advisor

Job Summary

A business services company is searching for a person to fill their position for a Remote Utilization Management RN Care Advisor.

Candidates will be responsible for the following:

• Performing accurate data entry
• Performing utilization review of inpatient admissions
• Accurately documenting all review determinations and contacts providers and members according to established timeframes

Qualifications for this position include:

• Associate or degree in nursing required
• Licensed registered nurse (current and unrestricted)
• Minimum of three years of direct clinical patient care
• Experience with clinical decision-making criteria sets (i.e., Milliman, InterQual)
• Minimum of one year of experience with medical management activities in a managed care environment
• Possess basic computer skills