Utilization Review RN

We are seeking a Utilization Review RN to examine medical records and develop concise clinical reviews to support authorization obtainment, avoid payment denial, and optimize reimbursement. The ideal candidate will have three years of healthcare clinical experience and a current Registered Nurse license.

Requirements

• Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC)
• Three years of healthcare clinical experience
• Bachelor's Degree in Nursing OR Associate of Science in Nursing Degree (ASN) or Diploma; Currently enrolled in a BSN program and BSN completion within three (3) years of hire
• Medical Management for Medicare and/or Medicaid populations
• Utilization Management experience

Benefits

• Health insurance
• Retirement plan
• Paid time off
• Holidays
• Life insurance
• Disability insurance

Originally posted on Himalayas