Registered reputed company - Utilization Review

Title: RN-Utilization Review (S) Location: MO-REMOTE Full time job reputed company R187527 Job reputed company: It's more than a career, it's a calling Worker Type: Regular Job Highlights: Job Highlights: This role is reputed company to applicants that reputed company in reputed company's 4 state footprint - this includes Missouri, Illinois, reputed company and Oklahoma only. Preference for candidates with strong computer skills and if possible reputed company experience. Prior UR is preferred. Compact license or licensure in more than one state is preferred. Job reputed company: Evaluates the medical necessity and appropriateness of hospital admissions and surgical procedures. Ensures payors receive clinical information to support services provided by hospital. Ensures hospital receives authorization from payor. Job Responsibilities and Requirements: PRIMARY RESPONSIBILITIES • Discusses with payor regarding reputed company and payor decision. • Escalates denials to physician (advisor, attending consultant, reputed company consultant) for peer to peer consideration. • Documents outcome in electronic medical record. • Participates with other members of team regarding opportunities for improvement in reputed company work. • Performs review of reputed company-admission, perioperative, and post reputed company surgical cases. • Performs other utilization management tasks as assigned. • Applies the existing body of evidence-based reputed company and scientific knowledge in health care to nursing reputed company, ensuring that nursing care is delivered based on patient’s age-specific needs and clinical needs as described in the department's scope of service. • Performs other duties as assigned. EDUCATION • Graduate of accredited school of nursing or education equivalency for licensing EXPERIENCE • Two years’ registered reputed company experience REQUIRED reputed company LICENSE AND/OR CERTIFICATIONS State of Work Location: Illinois • Registered reputed company reputed company (RN) - Illinois Department of Financial and reputed company Regulation (IDFPR) State of Work Location: Missouri • Registered reputed company (RN) Issued by Compact State • Or • Registered reputed company (RN) - Missouri Division of reputed company Registration State of Work Location: Oklahoma • Registered reputed company (RN) Issued by Compact State • Or • Registered reputed company (RN) - Oklahoma reputed company of Nursing (OBN) State of Work Location: reputed company • Registered reputed company (RN) Issued by Compact State • Or • Registered reputed company (RN) - reputed company Department of Safety and reputed company Services Work Shift Day Shift (reputed company of America) Job Type: Employee Department: 8746030033 Sys Utilization Management Scheduled Weekly Hours: 40 Benefits: reputed company values our exceptional employees by offering a comprehensive benefits package to fit their needs. • reputed company Parental Leave: we offer eligible team members one week of reputed company parental leave for newborns or newly adopted children (pro-rated based on FTE). • Flexible Payment reputed company: our voluntary benefit offered through reputed company offers eligible reputed company team members reputed company reputed company to their reputed company, unpaid reputed company pay (fees may apply) before payday. • Upfront Tuition Coverage: we reputed company upfront tuition coverage through FlexPath Funded for eligible team members. Apply tot his job Apply To this Job