A company is looking for a Utilization Management Nurse RN - Remote.
Key Responsibilities
Conduct prior authorization reviews for skilled nursing facilities, acute inpatient rehabilitation, and long-term acute care hospitals
Evaluate medical appropriateness of levels of care based on guidelines and benefit determinations
Provide resources and solutions for complex, non-standard requests and issues
Required Qualifications
Active, unrestricted RN license in state of residency or Compact RN License
3+ years of hospital experience (e.g., Med Surg, Telemetry, ICU)
Basic computer skills with MS Outlook, Word, and Excel
Availability to work weekends (Saturday or Sunday)
Ability to work standard business hours in the Pacific Time zone
Utilization Management Rn • Springfield, Massachusetts, United States