Nurse Utilization - Review Nurse

Job Title: Nurse Utilization - Review Nurse Location: Fully Remote must reside in - TX/IL/NM/OK/MT/TN Duration: 3 months+ Contract (Possible Extension) Schedule: Monday – Friday, 8:00 AM – 5:00 PM Pay Rate: $41 - $42/hr. on W2 Job Description · This is full time remote, but candidates must reside in the either of the five business plans: IL, TX, NM, MT,TN or OK · RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. · This Position Is Responsible for Performing Accurate and Timely Medical Review of Claims Suspended for Medical Necessity, Contract Interpretation, Pricing; And to Initiate And/Or Respond to Correspondence from Providers or Members Concerning Medical Determinations.