UM Nurse Clinical Reviewer - LPN RN Indiana

This job has been removed
Location: Remote
Compensation: To Be Discussed
Staff Reviewed: Wed, Jul 03, 2024
This job expires in: 11 days

Job Summary

A company is looking for a Utilization Management (UM) Nurse Clinical Reviewer - LPN/RN.

Key Responsibilities:
  • Perform various medical record reviews accurately and timely
  • Utilize clinical expertise to determine medical appropriateness
  • Assess workload, adjust schedules, and maintain quality monitoring activities

Required Qualifications:
  • Active LPN or RN license in Indiana or other applicable State/Clinical license
  • Graduate of an accredited Nursing Program
  • 2+ years of UM experience in State, Hospital, or Health Plan settings
  • Knowledge of InterQual or MCG criteria and NCQA/URAC standards
  • 2+ years of relevant clinical experience with strong clinical assessment and critical thinking skills

COMPLETE JOB DESCRIPTION

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