Remote UM Nurse - Pre-Service (Must have North Carolina LVN / RN License)

Nur für registrierte Mitglieder

Nevada (IA)

Remote

USD 77.000 - 117.000

Vollzeit

Vor 30+ Tagen

Zusammenfassung

An established industry player is seeking a dedicated Remote UM Nurse to join their Utilization Management team. This role involves reviewing pre-certification requests for medical necessity, collaborating with healthcare providers, and ensuring efficient processing of referrals. The ideal candidate will have a strong nursing background, experience in utilization management, and excellent communication skills. This position offers a unique opportunity to contribute to the well-being of seniors while working in a supportive and innovative environment. If you're passionate about making a difference in healthcare and thrive in a collaborative setting, this role is perfect for you.

Qualifikationen

3+ years nursing experience in clinical settings required.
Experience in Utilization Management and managed care is essential.

Aufgaben

Review pre-certification requests and ensure compliance with guidelines.
Collaborate with medical directors for timely processing of referrals.

Kenntnisse

Nursing Experience

Utilization Management

ICD-10 Coding

CPT Coding

Problem-Solving Skills

Communication Skills

Mathematical Skills

Ausbildung

High School Diploma or GED

Associates or Bachelor's degree in Nursing

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Jobbeschreibung

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Deine Position

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Dein Profil

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Leistungen

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