Remote RN — Utilization Review & Care Coordination
Sentara Health
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Vantaggi offerti da questo lavoro
Descrizione del lavoro
Sentara Health Plans Community Care is seeking an Utilization Review Nurse in Georgia. The role conducts prior authorization, clinical reviews, and care coordination to ensure treatment aligns with policies and eligibility.
The incumbent will review utilization against CMS/state criteria and support accreditation processes. The position requires an active RN license and at least 3 years of acute care experience.
Competenze
- Active RN license in good standing.
Mansioni
- Perform utilization management services including prior authorization and retrospective review.
Conoscenze
Formazione
Strumenti
Descrizione del lavoro
Sentara Health Plans Community Care is seeking an Utilization Review Nurse in Georgia. The role conducts prior authorization, clinical reviews, and care coordination to ensure treatment aligns with policies and eligibility.
The incumbent will review utilization against CMS/state criteria and support accreditation processes. The position requires an active RN license and at least 3 years of acute care experience.
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