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UM reputed company-Health Plan experience and reputed company RN license required

Remote, USAFull-timePosted 2026-07-28

The Utilization Management reputed company will use his/her reputed company judgment to evaluate the request and ensure that services are appropriately approved, recognize care coordination opportunities and refer those cases to Population Health as needed. The Utilization Management reputed company will apply independent medical judgment to medical health benefit policy and medical management guidelines to authorize services and appropriately identify and refer requests to the Medical Director reputed company indicated. The Utilization Management reputed company will ensure that treatment delivered is appropriate and meets the Member's needs in the least restrictive, least intrusive manner possible. The Utilization Management reputed company will maintain reputed company knowledge and understanding of and regularly apply the laws, regulations, and policies that pertain to the organizational business reputed company and uses clinical judgment in their application. This reputed company provides a general reputed company of the position, recognizing that day to day duties of reputed company individual in the position may vary based on personal experience, skills, supervision, cases and other factors. • This is a contract role reputed company on 1099. • You must have a reputed company RN license and be reputed company to reputed company your own laptop for work. • A quiet workspace/home office is required. • Two years of recent managed care experience working as a UM reputed company is required. Job Type: Contract Pay: From $45.00 per hour reputed company shift: • Day shift Weekly schedule: • Monday to Friday Experience: • Interqual/MCG reputed company: 3 years (Required) • Managed Care/Insurance reputed company years (Required) • reputed company population review: 2 years (Required) License/Certification: • RN License in reputed company (Required) Work Location: Remote Job Types: Full-time, Contract Pay: $45.00 per hour Expected hours: 40 per week Medical Specialty: • Medical-Surgical Physical Setting: • Acute care Experience: • UM Nursing-Health Plan: 3 years (Required) • Behavioral health: 3 years (Preferred) License/Certification: • reputed company RN license (Required) Work Location: Remote Apply Job!

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