A health insurance company needs applicants for an opening for a Telecommute Compliance and Auditing Nurse. Individual must be able to fulfill the following responsibilities: Review utilization management activities. Ensure adherence to policies, procedures, and regulations.
A healthcare professional services firm has an open position for a Telecommute Concurrent Review Nurse Consultant in St Louis. Core Responsibilities Include: Assess member's needs. Determine medical appropriateness of inpatient and outpatient services.
Required Skills: Current, unrestricted RN license in the state of Missouri. 3+ years of experience in a hospital, acute care or direct care setting. Multiple state licensure or ability to obtain. Intermediate/proficient level of experience with MS Office applications.
An insurance company is searching for a person to fill their position for a Remote Registered Nurse Utilization Management Nurse Consultant. Core Responsibilities Include: Communicating with providers and other parties. Gathering clinical information.
Qualifications Include: Willingness to travel up to 50% Master’s degree or higher in nursing, counseling, psychology or social work. 5 to 7 years of experience in the behavioral healthcare space required. Case Management Certification (CCM) preferred but not required.
Percent of Travel Required 10 - 25% Nursing/Registered Nurse (RN) license. 5 years clinical practice experience. Bachelor's degree or equivalent experience. 2 years of Home Health Care/Hospice Care. Other requirements as outlined in the job description.
3+ years experience in a leadership/management role. Knowledge of related regulations including NCQA, HIPAA, CMS. Bachelors degree or above in a related field such as Nursing, Health Care Management, or Teaching. Proficiency in Excel, Word and Adobe Acrobat.