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.
Conduct UM review. Required Skills: Current unencumbered RN license in Maryland and any other compact states. 2+ years of acute clinical experience. 4+ years of utilization management experience. Familiarity with Milliman and InterQual guidelines. Proficiency in Microsoft Word.