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Utilization Review Nurse (REMOTE)

Company: Adecco Medical & Science
Location: Grand Prairie
Posted on: November 18, 2021

Job Description:

WANTED! REMOTE RNS! READ REQUIREMENTS CAREFULLY BEFORE APPLYING -- Use your RN acumen to join a growing and exciting team while working from home! Be a part of an innovative company that is using leading technology to help patients live their best lives. -- Details:

  • FULL TIME only
  • Fully remote, must be hard wired
  • $43/hour -- Duties:
  • Applying criteria to inpatient admissions and performing concurrent review functions, identifying discharge planning needs and referrals to case management.
  • Evaluates clinical information submitted by providers against plan review criteria and benefit guidelines
  • Utilizes clinical information to determine if criteria for medical necessity and benefit guidelines are met
  • Documents all pertinent case information and dispositions for approvals and denials
  • Communicates with providers to initiate/coordinate outpatient services/discharge planning needs for members
  • Acts as a liaison to assure services are provided in the least restrictive, most cost effective and clinically appropriate setting -- Must Have:
  • Ability to work autonomously and as a team member
  • Capability to manage workload and schedule
  • Current RN license and at least 2 years of clinical experience in a hospital, acute care, direct care or utilization management.
  • Preferred: 2+ years of UM/CM experience; One of the following certifications: MCG, ACM, CCM, CMC, and/or CMCN If you are interested and qualify for the opportunity, please apply and include your resume. You can also email your resume to Thank you!Equal Opportunity Employer/Veterans/DisabledTo read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to Company will consider qualified applicants with arrest and conviction records

Keywords: Adecco Medical & Science, Grand Prairie , Utilization Review Nurse (REMOTE), Healthcare , Grand Prairie, Texas

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