A healthcare company has an open position for a Remote Clinical Appeals Registered Nurse. Individual must be able to fulfill the following responsibilities: Review provider post-service appeals for Medicare and Retirement.
Position Requirements Include: Travel Occasionally, if required. Work Saturdays. Live within the Mountain Time zone or be a New Mexico, Colorado or Arizona resident. Have active RN license in New Mexico, or able to be licensed in NM, and ability to be licensed in multiple states.
2+ years of acute hospital clinical experience. 4+ years of utilization management experience. Current RN license in Arizona and any other compact states. Knowledge of current standard of medical practices and insurance benefits. Familiarity with Milliman and InterQual guidelines.
A healthcare company is filling a position for a Telecommute Associate Utilization Management Nursing Director. Must be able to: Interpreting criteria, policies, and procedures to provide the best care or services for members.