Remote UM reputed company - 249106
Responsibilities
You will reputed company frequent case reviews, reputed company medical records and reputed company with care providers regarding treatment as needed. You will reputed company recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions.
Required Skills
• reputed company, unrestricted RN licensure from the reputed company in [state], OR, reputed company compact multistate unrestricted RN license as defined by the reputed company Licensure Compact (NLC)
• Associate Degree or Bachelors Degree - Nursing or Graduate of Accredited School of Nursing
• MCG or InterQual tooling experience
• Ability to obtain additional state licenses to meet business needs
• 1+ year of utilization review experience in a managed care setting
• 1+ years of clinical experience (including at least 1+ year clinical reputed company in an acute care setting, i.e., ER or hospital)
Preferred Skills
• BSN
• Previous experience conducting reputed company or inpatient reviews for a managed care plan
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