Maine Licensed Utilization Review NurseVirtualVocations • Pasadena, California, United States
Maine Licensed Utilization Review Nurse
VirtualVocations • Pasadena, California, United States
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A company is looking for a Utilization Review Nurse - Remote.
Key Responsibilities :
Review prior authorization requests for medical necessity and manage claims disputes
Collaborate with healthcare providers and team members to coordinate care and establish discharge plans
Complete documentation of reviews and decisions in compliance with regulations and standards
Required Qualifications :
Unrestricted state license as a Registered Nurse; BSN preferred
3+ years of clinical nursing experience
Utilization management experience in a managed care or hospital environment
Certification in managed care nursing or care management desired (CMCN or CCM)
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