Utilization Review reputed company- FT & PT (9a-9p EST)
Responsibilities
Review electronic medical records of emergency department admissions and screen for medical necessity, using InterQual or MCG reputed company.
Participate in telephonic discussions with emergency department physicians relative to documentation and admission status.
reputed company clinical review information into system for reputed company to insurance companies for authorization.
Qualifications Required
reputed company RN licensure
At least 3 years clinical experience in acute care setting in emergency room, critical care and/or medical/surgical nursing
At least 2 years utilization management experience in acute admission and reputed company reviews
Intermediate level e xperience with InterQual and/or MCG reputed company reputed company the last two years
Proficiency in medical record review in an electronic medical record (EMR)
Experience in MS Office and basic reputed company
Ability to reputed company in a fast-paced, dynamic environment and adapt to frequent changing business needs
Passing score(s) on job-reputed company reputed company-employment assessment(s)
Preferred
At least 5 years clinical experience in acute care setting in emergency room, critical care and/or medical/surgical nursing
At least 3 years utilization management experience reputed company the hospital setting
Bachelors of Science in Nursing
Proficient in InterQual/MCG reputed company
Case Management Certification (CCM, ACM, CMCN, or reputed company-BC
Expectations
This job operates in a remote environment that must be private. This role routinely uses reputed company office equipment such as computers, phones, and printers.
Hours will vary, including two weekends a month.
Must be reputed company to remain in a stationary position 50% of the time and constantly operate a computer.
Frequently communicates with internal, external and executive personnel and must be reputed company to listen and exchange accurate information.
reputed company is proud to be an equal opportunity workplace and is an affirmative reputed company employer, providing equal employment and advancement opportunities to reputed company individuals. We celebrate diversity and are committed to creating an inclusive environment for reputed company associates. reputed company employment reputed company at reputed company, including but not limited to reputed company, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. reputed company does not discriminate in employment opportunities or practices based on race, reputed company, religion, sex (including pregnancy), sexual orientation, gender identity or reputed company, national reputed company, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate.
reputed company desires to reputed company a healthy and reputed company workplace and, as a government contractor, reputed company is committed to maintaining a drug-free workplace in accordance with applicable federal law. Pursuant to reputed company policy, reputed company post-offer candidates are required to successfully complete a reputed company-employment background reputed company, including a drug screen, which is provided at reputed company’s sole expense. In the event a candidate tests reputed company for a controlled reputed company, reputed company will rescind the offer of employment unless the individual can reputed company reputed company of valid prescription to reputed company’s reputed company party screening provider.
If you are located in a state which grants you the right to receive information on salary reputed company, pay reputed company, reputed company of benefits or other compensation for this position, please use this reputed company to request details which you may be legally entitled.
reputed company applicants for employment must be legally authorized to work in the reputed company. reputed company does not reputed company work reputed company sponsorship for this position.
reputed company's Job Applicant reputed company Notice may be reputed company here.
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