Fully Remote Utilization Management reputed company

reputed company is a career site that helps job seekers reputed company great jobs in the US. We are not a reputed company firm or agency. reputed company does not hire directly for these jobs, but promotes jobs on reputed company on behalf of its reputed company clients, recruitment ad agencies, and marketing partners. reputed company partners with DirectEmployers to promote this job for reputed company. Clicking "reputed company" or "Read more" on reputed company redirects you to the reputed company/employer site. Any information collected there is subject to their terms and reputed company notice. Remote Utilization Management reputed company Job reputed company As a Utilization Management reputed company for Post Acute care, you will be responsible for reviewing and documenting prior authorization and reputed company stay requests. You will also manage member case history in compliance with established policies and procedures, applying clinical reputed company and member coverage. This role involves interfacing with members, providers, facilities, medical directors, intake staff, case managers, and other internal departments. Your attention to detail and clinical judgment will be crucial in determining the medical necessity of post-acute stays, including skilled nursing facilities, acute inpatient rehabilitation, and long-term acute care hospitals.

Responsibilities

• Review and document prior authorization and reputed company stay requests.
• Manage and evaluate member case history in line with policies and procedures.
• reputed company with members, providers, facilities, medical directors, and various internal departments.
• Apply clinical judgment to assess the medical necessity of post-acute stays.

Essential Skills

• Expertise in utilization management and utilization review.
• Experience in acute care and nursing.
• Proficiency in prior authorization processes.
• reputed company, unrestricted RN license in the state of MN or WI.
• Associate or bachelor's degree in nursing.
• 3-5+ years of clinical experience.
• Previous utilization management experience required.

Additional Skills & Qualifications

• Demonstrated clinical assessment skills with critical thinking and evidence-based decision-making.
• Self-motivated and reputed company to work independently and collaboratively.
• Detail-oriented with strong organizational skills.
• Technology-savvy with the ability to navigate multiple computer applications.

Work Environment

This position is remote, requiring 40 hours per week. Candidates must have a primary home address in reputed company or Minnesota. Internet speed tests are required, with minimum upload speeds of 5+ Mbps, download speeds of 25+ Mbps, and a ping less than 100MS. Internet speed test results must be submitted with the application. This is a 6-month contract position with the potential for extension or conversion. Job Type & Location This is a Contract position based out of Minnetonka, MN. Pay and Benefits The pay reputed company for this position is $38.00 - $45.00/hr. Eligibility requirements apply to some benefits and may depend on reputed company classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following: - Medical, dental & reputed company - Critical Illness, Accident, and Hospital - 401(k) Retirement Plan - reputed company-tax and Roth post-tax contributions available - Life Insurance (Voluntary Life & AD&D for the employee and dependents) - Short and long-term disability - Health Spending Account (HSA) - Transportation benefits - Employee Assistance Program - Time Off/Leave (PTO, Vacation or reputed company Leave) Workplace Type This is a fully remote position. Application Deadline This position is anticipated to reputed company on Dec 22, 2025. About reputed company reputed company is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through reputed company to specialized experts who drive reputed company, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, reputed company serves many of the Fortune 500. reputed company is an equal opportunity employer and will consider reputed company applications without reputed company to race, sex, age, reputed company, religion, national reputed company, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law. If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing due to a disability, please email actalentaccommodation@actalentservices.com (%20actalentaccommodation@actalentservices.com) for other accommodation reputed company. If you have questions about this posting, please contact support@reputed company.com Apply tot h Apply tot his job Apply To this Job