State Licensed Appeals Nurse Consultant
VirtualVocationsGainesville, Florida, United Statesjob_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_description
A company is looking for a Utilization Management Appeals Nurse Consultant (Remote).
Key Responsibilities
Administers review and resolution of clinical complaints and appeals
Interprets data from clinical records to apply appropriate clinical criteria and policies
Coordinates clinical resolutions with internal and external support areas
Required Qualifications
3+ years of Utilization Management or Utilization Review experience
3+ years of clinical nursing experience, with 1-3 years in managed care
1+ year of experience with ICD-9, CPT coding, and HCPC
1+ year of experience with clinical and medical policy, including Milliman Care Guidelines or InterQual
Active, unrestricted RN license in the state of residence
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Licensed Nurse • Gainesville, Florida, United States
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