Remote RN Utilization Review Case Manager | Benefits

Viva Health; Birmingham (AL); Hybrid; USD 65,000 - 90,000; Full time

Benefits offered by this job

Tuition reimbursement

401(k)

Paid parental leave

Community service day

Work-from-home opportunities

Job summary

Viva Health in Birmingham, AL seeks a Case Manager, Utilization Review to join our team. You will help develop and coordinate utilization review activities, perform medical records checks, and determine medical necessity for admissions. Some duties may be performed on-site, telephonically, or travel within the service area.

Work-from-home opportunities may be available based on duties. Requirements include an ADN/BSN and an active RN license in Alabama, with at least three years of clinical

Qualifications

• Graduate of a professional nursing program (ADN/BSN).
• Current RN license in good standing with Alabama Board of Nursing.
• Minimum of three years of clinical experience in acute, post-acute, or behavioral health settings.
• Knowledge of Medicare and Medicaid regulations.
• Willing to submit to vaccine testing and screening.
• Strong customer service and written/verbal communication skills.
• Basic computer skills for record-keeping and scheduling.

Responsibilities

• Assist in development, planning, coordination and administration of utilization review.
• Perform timely medical records checks to determine admission appropriateness and medical necessity.
• Work on-site or telephonically; may travel within Viva Health service area.
• Opportunity to work from home consistent with job duties and policy.

Skills

RN licensure in Alabama

ADN/BSN graduate

3 years clinical experience

Vaccine testing and screening

Medicare/Medicaid knowledge

Customer service & communication

Basic computer skills

Flexibility/adaptability

Education

BSN or ADN

Job description

Viva Health in Birmingham, AL seeks a Case Manager, Utilization Review to join our team. You will help develop and coordinate utilization review activities, perform medical records checks, and determine medical necessity for admissions. Some duties may be performed on-site, telephonically, or travel within the service area.

Work-from-home opportunities may be available based on duties. Requirements include an ADN/BSN and an active RN license in Alabama, with at least three years of clinical