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