TELEPHONE UTILIZATION REVIEW NURSE
The Registered Nurse will assess inpatient services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines. The Registered Nurse will complete medical necessity and level of care reviews for requested services using clinical judgment and refer to medical directors for review depending on case findings. Educate providers on utilization and medical management processes. The Registered Nurse will ensure that patients progress toward desired outcomes with quality care that is medically appropriate and cost-effective based on the severity of illness and the site of service.
REGISTERED NURSE QUALIFICATIONS:
- Active RN / Registered Nurse License in Arkansas
- Associate Degree Required
- 3+ years of acute care/clinical experience (ICU, ER, Med/Surg)
- NICE TO HAVE: Managed Care, Utilization Review OR Prior Authorization experience
WHAT’S GREAT ABOUT THIS POSITION FOR A REGISTERED NURSE?
- Full-time opportunity with a major Fortune 100 Managed Care Organization
- Telephonic office-based position; NO REMOTE OPTIONS AVAILABLE
- Opportunity to step away from the bedside/direct patient care
- Competitive benefits!
SALARY: Call to Inquire
PLEASE CONTACT: Alliston Brown / Phone number blocked - click to apply or Phone number blocked - click to apply, EXT 229
registered nurse, RN, insurance, managed care, acute care, clinical, hospital, emergency room, ICU, intensive care, medical surgical, telemetry, telephone, telephonic, utilization review, utilization management, concurrent review, prior authorization
Registered Nurse Certified
Intensive Care Unit