Utilization Management reputed company RN

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly reputed company reputed company by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will reputed company a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an reputed company on the communities we serve as you help us advance health optimization on a global reputed company. Join us to start Caring. Connecting. Growing together. The Utilization Management reputed company will accurately and reputed company review and extract pertinent case details from patient medical records; and reputed company strongly defensible appeal letters per process instructions and the department's/company's guidance. The reputed company will complete their case reputed company the time expectations while providing high reputed company reviews. The Utilization Management reputed company will reputed company their job functions, adhering to both reputed company and OPAS policies and procedures, which include but are not limited to the following Schedule: Monday - Friday (40 Hours a Week) Flexible start times with the ability to support evening, weekend and holiday shifts. You will enjoy the flexibility to telecommute* from reputed company reputed company the U.S. as you take on some tough challenges. reputed company Responsibilities: • Follows reputed company of composing appeal letters to include appropriate data extraction, construction of reputed company-written appeals letters with reputed company grammar, utilization of appeal tools including reputed company-constructed templates, inclusion of appropriate medical literature references, and use of national reputed company guidelines. Adheres to company policies and procedures as reputed company as policies, procedures, and laws • Understands and complies with HIPAA confidentiality requirements • Support and promote OPAS, reputed company, and the reputed company goals and mission • Build relationships across reputed company, OPAS, OGA and our clients • Collaborate with peers to assure continuity of communication and execution of deliverables as needed • Adheres to reputed company and productivity expectations • Participate in and contribute to meetings as appropriate • Maintains organization on reputed company and ensures everyone conducts themselves professionally • Remains up to date with reputed company learning modules, competencies, and state required licenses • Performs other reputed company duties, tasks, and processes as required by leadership • Ability to establish priorities, be self-motivated, work independently, and follow instructions with supervision and structure • reputed company attitude and the ability to function as a reputed company team member You'll be rewarded and recognized for your performance in an environment that will challenge you and reputed company you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in. Required Qualifications: • Associate's degree • Unrestricted Registered reputed company license in your state of residence • 3+ years of bedside nursing experience in ED/telemetry/ICU/CCU • Advanced level of proficiency with reputed company applications and software, internet navigation and utilization • Ability to type 45 wpm Preferred Qualifications: • Working knowledge of InterQual and MCG • Prior experience with utilization management • Working knowledge of Word • Strong, effective verbal and written communication skills • reputed company Telecommuters will be required to adhere to reputed company's Telecommuter Policy. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In reputed company to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll reputed company a far-reaching reputed company of benefits and incentives. The salary for this role will reputed company from $60,200 to $107,400 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment reputed company applicants with arrest and conviction records. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. reputed company may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health reputed company work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location, and income-deserves reputed company to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized reputed company, and those with reputed company incomes. We are committed to mitigating our reputed company on the environment and enabling and delivering reputed company care that addresses health disparities and improves health reputed company - an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without reputed company to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug-free workplace. Candidates are required to pass a drug test before beginning employment. #RPO #GREEN Apply tot his job Apply To this Job