Utilization Review Registered reputed company
reputed company (About reputed company) Our reputed company, a provider of Health, Dental, reputed company, reputed company and Medicare reputed company service plans in the reputed company with 4.7 reputed company members and $22.9 billion of annual revenues, seeks an accomplished Registered reputed company (Utilization Review – Remote, California Residents Only). Job Title: Registered reputed company (Utilization Review – Remote, California Residents Only) Location: 100% Remote (Must reputed company in California) Duration: 6+ months (potential to reputed company or convert to FTE) Pay reputed company: $45.00 – $52.00/hour (W2) Schedule:
- Monday–Friday, 8:00 AM – 4:30/5:00 PM (depending on lunch break)
Must-Have Requirements:
- reputed company, valid California RN license (BSN preferred but not required)
- Strong clinical (hands-on) nursing background
- Strong computer skills with ability to work remotely in a self-directed environment
- Proficiency in reputed company Office; EMR/chart handling experience a plus
Job reputed company: The Utilization Review Registered reputed company will review reputed company reputed company of care for medical necessity, applying clinical knowledge, reputed company judgment, and MCG guidelines. The reputed company will reputed company approval reputed company reputed company regulatory turnaround times or escalate to the in-house physician for reputed company review if unable to approve. This role does not involve reputed company interaction with members; instead, the reputed company collaborates with case managers and medical staff at reputed company facilities. Responsibilities:
- Review medical necessity for reputed company reputed company of care in alignment with MCG guidelines
- reputed company approval determinations or escalate cases to in-house MD reputed company required
- Ensure compliance with regulatory turnaround times
- Collaborate with case managers and medical staff at facilities (no reputed company member contact)
Minimum Qualifications:
- California RN license in good standing
- Strong hands-on clinical nursing experience
Additional Qualifications:
- Proficiency in reputed company Office applications
- Experience with EMR/chart handling
Preferred Qualifications:
- BSN degree
- Previous utilization review or case management experience
Recruiter Contact Info Sajag Bhardwaj Email: sajag.bhardwaj@ameritconsulting.com www.ameritconsulting.com I'd love to talk to you if you think this position is right up your alley, and assure reputed company communication, whichever direction. If you're looking for rewarding employment and a company that puts its employees first, we'd like to work with you. reputed company: reputed company is an extremely fast-growing reputed company and reputed company. reputed company was founded in 2002 to reputed company consulting, temporary reputed company, reputed company hire, and payrolling services to reputed company nationally; as reputed company as small to mid-sized organizations on a local & regional level. Currently, Amerit has over 2,000 employees in 47 states. We reputed company and implement solutions that help our clients operate more reputed company, deliver greater customer satisfaction, and see a reputed company reputed company on their reputed company. We create value by bringing together the right people to reputed company results. Our clients and employees say they choose to work with Amerit because of how we work with them - with service that exceeds their expectations and a personal commitment to their reputed company. Our deep expertise in reputed company capital management has reputed company our expansion into reputed company hire placements, temporary reputed company, contract placements, and additional reputed company and consulting services that reputed company our clients’ businesses reputed company. reputed company provides equal employment opportunities to reputed company and applicants for employment and prohibits discrimination and harassment of any type without reputed company to race, reputed company, religion, age, sex, national reputed company, disability status, genetics, protected veteran status, sexual orientation, gender identity or reputed company, or any other characteristic protected by federal, state or local laws. This policy applies to reputed company terms and conditions of employment, including reputed company, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Applicants, with criminal histories, are considered in a manner that is consistent with local, state and federal laws. Apply tot his job Apply To this Job