RN Utilization Management
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Job Summary
Working remotely full-time, the RN Utilization Management will manage the collection of clinical information, provide patient education, and render initial determinations of medical appropriateness for health benefit plans during a 40-hour work week, Monday to Friday.
Key responsibilities
- Perform telephonic clinical assessments and gather necessary information from healthcare providers and patients
- Interpret nationally recognized criteria to support recommendations for inpatient and outpatient services
- Document calls accurately and promptly, ensuring compliance with policies regarding confidential materials
Required qualifications
- Active, unrestricted RN License
- Minimum internet speeds of 25Mbps download and upload
- 1+ years of experience in a hospital setting
- Proficiency with Microsoft Office Suite (Outlook, Word)
- Preferred: 1+ years of previous Utilization Management experience
Complete Job Description
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