Utilization Review-RN’s (MEO-537B)
They do hire in all states, but preference in “compact nursing states” Arizona, Arkansas, Colorado, Delaware, Kentucky, Idaho, Indiana, Iowa, Maine, Mississippi, Maryland, Missouri, Nebraska, New Mexico, North Carolina, North Dakota, New Hampshire, South Carolina, South Dakota, Tennessee, Texas, Utah, and Virginia and Wisconsin
Primary Responsibilities: Perform utilization management, utilization review, or concurrent review (on-site or telephonic inpatient care management). Determine medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination.
Minimum Requirements: Unrestricted RN license, 2+ years’ clinical experience within the hospital setting, with an understanding of the inpatient management and plan of care process. Basic level of experience with Microsoft Word – with the ability to navigate a Windows environment.
Preferred qualifications: Pre-authorization experience; Previous UM experience and/or Managed Care experience; Background in concurrent review; Discharge planning experience; Case management experience; Knowledge of Milliman or Interqual guidelines and CCM designation.
* The above job descriptions and listed requirements can often change based on current Employer need and new projects. Your assigned job counselor will provide you with the most up-to-date job information.
No Phone calls – All applications must be submitted using our pre-qualify form: http://myemploymentoptions.