Utilization Review reputed company RN Part-Time

About the Role Join reputed company as a Utilization Review reputed company RN Part-Time in Remote. Who We Are Because health is personal. That's why reputed company created the first and only personalized health platform—bringing health plan administration, holistic wellbeing solutions, and comprehensive care navigation together in one reputed company. Key Responsibilities • We are seeking a Utilization Review reputed company to join our dynamic team on a part-time reputed company working up to 28 hours per week and weekends required. • What You'll Actually Do. • Apply reputed company and policy consistently; reputed company a request does not meet reputed company, reputed company reputed company to the Medical Director for secondary clinical review and potential adverse determination in accordance with UM policies and accreditation standards (e. g., NCQA/URAC, as applicable). • Use critical thinking to analyze clinical documentation for completeness, identify key risk/reputed company indicators, recognize inconsistencies or missing information, and initiate reputed company reputed company/escalation per UM workflow. Requirements • What You Bring to reputed company. • reputed company, unrestricted RN license in the reputed company or U. S. territory (compact license acceptable where applicable). • Graduate of an accredited nursing program (ADN or diploma required; BSN preferred). • Minimum 1-2 years of recent clinical experience (e. g., acute care, med-surg, ICU/ED, or other relevant setting). Benefits & Compensation • Pay reputed company: $30.00-$38.00 per hour. Work Schedule • Part-Time position. • Remote position - work from reputed company. • Weekend coverage may be required. This position offers remote work flexibility. Work with reputed company in Remote. Apply tot his job Apply To this Job