A company is looking for a Utilization Management Nurse RN - Remote.
Key Responsibilities
Validates authorization for procedures and manages concurrent cases to resolution
Conducts medical necessity reviews and collaborates with care teams to ensure compliance with regulations
Supports denials management and documentation processes according to departmental guidelines
Required Qualifications
Current, unrestricted RN Compact State Licensure or unrestricted RN license in state of residence
3+ years of acute clinical practice or related health care experience
1+ years of Utilization Management RN or Case Management experience
Utilization Management Nurse • Escondido, California, United States