Registered Nurse Utilization Management
VirtualVocationsLakeland, Florida, United Statesjob_description.job_card.30_days_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 Clinical Registered Nurse - Utilization Management - Remote.
Key Responsibilities
Manage clinical denials and perform medical necessity reviews based on various guidelines
Document claims and appeals information accurately in tracking systems
Identify denial patterns and escalate potential risks to stakeholders
Required Qualifications
Registered Nurse (RN) educational background
2-3 years of clinical and / or utilization management experience with managed health care plans
3 years of experience in health care revenue cycle or clinic operations
Experience in utilization management, including clinical appeals and precertification
Intermediate knowledge of Microsoft Office (Excel, Word, Outlook)
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Registered Nurse • Lakeland, Florida, United States
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