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Utilization Management RN job in Atlanta at The Judge Group

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Utilization Management RN at The Judge Group

Utilization Management RN

The Judge Group REMOTE Full Time
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Location: REMOTE
Description:
Are you a Registered Nurse with experience conducting appeals and denials? Then send your updated resume to [ Email address blocked ] - Click here to apply to Utilization Management RN. Honestly, everyone can send me their resume because then we can save some time and discuss available roles based on what you're looking for. 

Job Details:
Title: Utilization Management RN
Location: Remote but must be located in: TN, GA, AL, MS or NC
Hours: M-F day, Business hours
Length of Engagement: Contract 3+ months
Rate: Competitive and Dependent on Experience
Qualifications:
  • RN License in Tennessee or Compact State 
  • At least 2 years varied clinical experience
  • Utilization management (Payor side)
  • Excellent computer skills
  • Recent acute care hospital experience
  • Knowledge of CMS guidelines
Responsibilities:
  • Writing CMS denial letters and letters for Medicare
  • Experience reviewing for approval/denial for Medicare and authorization requests.
  • Performs comprehensive reviews of authorization requests using CMS and MCG guidelines
  • Performs thorough research and provides complete documentation. 
  • Initiate referrals to accomplish discharge planning.
  • Assist non-clinical staff in performance of administrative reviews. 
  • Interact with Onsite and Case Management areas to ensure smooth transfer of member information across the continuum of care. 
  • Apply established vendor protocols for authorization processes 

It's probably safe to say you're interested if you made it this far. Go ahead and send your updated resume to [ Email address blocked ] - Click here to apply to Utilization Management RN or share this job with your network.

I look forward to hearing from you!
Megan Huggins 
Direct line:
484-434-2946
 
Recruiter, The Judge Group


Contact: [ Link removed ] - Click here to apply to Utilization Management RN
This job and many more are available through The Judge Group. Find us on the web at [ Link removed ] - Click here to apply to Utilization Management RN
 

Recommended Skills

  • Authorization (Medical)
  • Authorization (Computing)
  • Case Management
  • Utilization Management
  • Acute Care
  • Clinical Works
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