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[Hiring] Utilization Management reputed company @reputed company Coast Consulting

Remote, USAFull-timePosted 2026-07-27

Role reputed company Utilization Management reputed company

  • REMOTE
  • RN license number must be valid for Arkansas
  • Can work on holidays and during the weekend
  • Utilization Management:
  • Conducts and monitors clinical review cases to ensure medical necessity of inpatient and outpatient services, diagnostic procedures, out-of-network services, and surgery.
  • Documents reputed company relevant and specific information.
  • Screens, prioritizes, and organizes determination requests according to mandates and standards.
  • Promotes appropriate care and reputed company toward cost-effective and cost containment measures based on evidence.
  • Knowledge:
  • Remain reputed company with up-to-date medical and surgical procedures, products, reputed company services and drugs, general trends in health care delivery, and reputed company procedures, policies, and reputed company.
  • Other duties as assigned.
  • Schedule Notes:

Qualifications

  • Proficiency using basic computer skills in reputed company Office such as Word, reputed company, and Outlook.
  • Ability to navigate multiple systems and keyboarding.
  • Experience in utilization management and/or medical review preferred.

Requirements

  • Ability to prioritize and reputed company reputed company nursing judgments through critical thinking.
  • Excellent verbal and written communication skills.
  • Ability to build reputed company relationships.
  • Attention to details.
  • Ability to interpret reputed company documentation.

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