Job is Expired
Location: Alabama, Arizona, Arkansas, Colorado, Idaho, Kansas, Louisiana, Mississippi, Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oklahoma, Oregon, South Dakota, Tennessee, Texas, Utah, Washington, Wisconsin, Wyoming
Compensation: To Be Discussed
Staff Reviewed: Fri, Nov 20, 2020
Job Summary
A privately-held healthcare technology solutions company is filling a position for a Remote Utilization Review RN.
Core Responsibilities Include:
- Manage utilization and, if necessary, discuss utilization of service and standards of patient management
- Perform initial, concurrent, and/or retrospective review of services that require prior authorization or medical appropriateness review
- Document clinical appropriateness reviews and care management activities in managed care operating systems
Must meet the following requirements for consideration:
- RN required; Preferred: Bachelor’s Degree in Nursing
- Minimum of 3-5 years of clinical experience
- Minimum one year of care management, utilization management experience, clinical documentation or clinical auditing experience
- Arizona or Multi State Nursing License (compact license) required
- Excellent computer literacy and beginning to moderate skills level with Microsoft Word and Excel
