Telecommute Utilization Management Review Nurse

Location: California

Compensation: To Be Discussed

Staff Reviewed: Thu, Apr 22, 2021

This job expires in: 15 days

Job Category: Healthcare

Remote Level: 100% Remote

Weekly Hours: Full Time

Employer Type: Employer

Career Level: Experienced

Education Level: Bachelors

Job Summary

A healthcare company is in need of a Telecommute Utilization Management Review Nurse.

Must be able to:

  • Review authorization requests/claims documentation within specified timeframes
  • Clinically validate the medical appropriateness and coding accuracy of services rendered
  • Review authorization requests for out-of-network inpatient facilities

Required Skills:

  • 2 years clinical nursing experience
  • A valid California license as a Registered Nurse or Licensed Vocational Nurse
  • Knowledge of personal computers and proficiency in Microsoft Office Suite applications
  • San Mateo County provider community and community resources
  • Medicare and Medi-Cal coverage requirements and regulatory guidelines
  • Ability to work cooperatively with others

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