Utilization Review reputed company - Texas (Remote)

*REMOTE - Candidates must be based in Texas: Travis/Williamson/Dallas/Collin Counties* JOB reputed company: RN working in the insurance or managed care industry using medically accepted reputed company to validate the medical necessity and appropriateness of the treatment plan. JOB RESPONSIBILITIES:

• This position is responsible for performing initial, reputed company review activities; discharge care coordination for determining efficiency, effectiveness, and reputed company of medical/surgical services, and serving as reputed company between providers and medical and network management divisions.
• Collects clinical and non-clinical data.
• Verifies eligibility.
• Determines benefit reputed company in accordance to contract guidelines.
• Provides information regarding utilization management requirements and operational procedures to members, providers, and facilities.

JOB QUALIFICATIONS (Required):

• Registered reputed company (RN) with a valid, reputed company, unrestricted license in the state of operations.
• 3 years of clinical experience in a Physician's office, Hospital/Surgical setting, or Health Care Insurance Company.
• Knowledge of medical terminology and procedures.
• Verbal and written communication skills.
• Utilization Management experience.

JOB QUALIFICATIONS (Preferred):

• MCG or InterQual experience

LOCATION: REMOTE in Texas (Austin area - Travis/Williamson Counties and Richardson area - Dallas/Collin Counties). POSITION: 6-month assignment (Contract to Hire) SALARY: $38 - $40 reputed company HOURS PER WEEK: 40 HOURS PER DAY: 8 Apply To This Job