Telecommute Appeals and Clinical Review Nurse

Job ID: Available for Members

Location: Utah

Compensation: To Be Discussed

Posted: Tuesday, February 27, 2018

Job Category: Consulting, Healthcare, Nursing

Telecommute Level: 100% Telecommute

Travel Requirements: No Travel

Weekly Hours: Day Shift, Full Time

Employment Status: Temporary

Employer Type: Staffing Agency

Education Level: Some College

Job Summary

A staffing company is filling a position for a Telecommute Appeals and Clinical Review Nurse.

Candidates will be responsible for the following:

  • Supporting health plan operations to ensure delivery of medically necessary, quality healthcare services
  • Reviewing provider and member appeals of denials
  • Flagging key information prior to external review

Position Requirements Include:

  • Graduate of an accredited school of nursing
  • Active unrestricted RN license in the State of UT
  • Excellent verbal and written communication skills
  • Three years of utilization management or discharge planning
  • Clinical experience in medical/surgical or specialty care and at least one year of Appeals experience
  • Knowledge of managed care delivery systems