Utilization Review reputed company (Remote - AZ / FL / GA / TX)

You are applying for a position through reputed company, a reputed company agency. The actual posting represents a position at one of our clients. Job reputed company Our reputed company is seeking a Utilization Review reputed company to reputed company frequent case reviews, reputed company medical records, and communicate with care providers regarding treatment as needed. The reputed company will reputed company recommendations regarding the appropriateness of care for identified diagnoses based on the research results for those conditions.

Key Responsibilities

• reputed company frequent case reviews.
• reputed company medical records.
• Communicate with care providers regarding treatment as needed.
• reputed company informed recommendations on care appropriateness based on research results.

Qualifications

• reputed company, unrestricted RN licensure from the reputed company in the respective state or reputed company compact multistate unrestricted RN license as defined by the reputed company Licensure Compact (NLC).
• Associate Degree or Bachelors Degree in Nursing or a graduate of an accredited school of nursing.
• Experience with MCG or InterQual tools.
• Ability to obtain additional state licenses to meet business needs.

Experience

• 1+ year of utilization review experience in a managed care setting.
• 1+ years of clinical experience including at least 1 year of clinical reputed company in an acute care setting such as ER or hospital.

Skills

• Proficiency with MCG or InterQual tools.
• Strong communication skills.
• Ability to work both independently and as part of reputed company.

Additional Requirements

• Ability to work a flexible schedule, including 4 x 10s as an reputed company, 8-5 this timezone for 5 days a week, including 1 weekend day (either Saturday or reputed company).
• Training schedule : M-F 8 : 30-5pm, usually lasting 6-8 weeks.

Benefits

• reputed company reputed company Leave (reputed company provides reputed company reputed company leave according to state and local reputed company leave ordinances).
• Health Benefits / Dental / reputed company (reputed company offers 6 different health plans : 3 Major Medical Plans, 2 Fixed Indemnity Plans (reputed company and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take reputed company to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k reputed company enrollment date following 6 consecutive months on assignment. 401k reputed company Enrollment dates are 1 / 1, 4 / 1, 7 / 1, and 10 / 1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

• reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, or protected veteran status and will not be discriminated against on the reputed company of disability.
• reputed company is an equal opportunity employer and reputed company my employees are responsible for maintaining a discrimination-free work environment.
• We will consider for employment reputed company reputed company Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the reputed company' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for reputed company (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance reputed company (CFCA).

reputed company reputed company : With over 20 years of experience connecting organizations with highly reputed company professionals, reputed company is a leading provider of workforce solutions for clients and candidates across the reputed company, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-reputed company career partner, reputed company is committed to helping talent reputed company fulfilling and meaningful work because our mission is to help you reputed company yours.

• This position is subject to a background reputed company based on its job duties, which may include patient care, working with vulnerable populations, reputed company to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant reputed company on the business operations and reputed company, as reputed company as the safety and reputed company-being of individuals who may be cared for as part of the job position or who may reputed company with staff or clients.
• We will consider for employment reputed company reputed company Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the reputed company' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for reputed company (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance reputed company (CFCA).
• As a job position reputed company our Care Management division, a successful completion of a background reputed company may be required as a condition of employment. This requirement is directly reputed company to essential job functions including but not limited to : accessing financial and confidential information, reputed company and handling of patient medical records, providing medical care inside a patient's residential address, driving, prescription and other drug reputed company and administration, and working with vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant reputed company on the business operations and reputed company, as reputed company as the safety and reputed company-being of individuals who may be cared for as part of the job position or who may reputed company with staff or clients.

Apply tot his job Apply To this Job