Job Summary
A professional services firm specializing in IT, healthcare, and accounting needs applicants for an opening for a Telecommute Concurrent Review Nurse in Albany.
Core Responsibilities of this position include:
- Assessing member’s needs
- Identifying solutions to problems and non-standard requests
- Conducting UM reviews and discharge planning at the facility level
Qualifications Include:
- Have RN license for the state of NY and any other compact states
- Have a minimum 2+ years acute clinical experience
- Have 4+ years of utilization management experience
- Able to work remotely and attend daily calls
- Familiar with Milliman and InterQual guidelines
- Have knowledge of current medical practices and insurance benefit standards