Remote Utilization Review Registered Nurse

Location: Mountain Time, Central Time

Compensation: To Be Discussed

Staff Reviewed: Tue, Sep 21, 2021

This job expires in: 6 days

Job Category: Healthcare

Remote Level: 100% Remote

Employer Type: Staffing Agency

Career Level: Experienced

Job Summary

A healthcare staffing and recruiting firm has an open position for a Remote Utilization Review Registered Nurse.

Candidates will be responsible for the following:

  • Utilizing clinical skills to telephonically provide and facilitate utilization review
  • Performing reviews of services, and determine medical appropriateness of inpatient and outpatient services
  • Obtaining the information necessary to assess a member's clinical condition

Must meet the following requirements for consideration:

  • 5 years acute care clinical nursing experience is required
  • Current, valid, and unrestricted state Registered Nurse (R.N.) license in a compact state
  • Experience using Milliman or InterQual criteria for medical necessity, setting and level of care, and concurrent patient management
  • 2 year of recent experience in Utilization Review or Utilization Management at a Health Plan or other Managed Care Organization
  • Computer skills to include Microsoft Word, Excel, database use, and basic data entry

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