Remote Utilization Review Nurse | Case Management

Iconma Portal; United States; Remote; USD 65,000 - 85,000; Full time

Benefits offered by this job

Health benefits

Referral program

Career growth opportunities

Job summary

Iconma Portal is seeking a Registered Nurse-Review Analyst for a remote position with a Health Insurance client. You will conduct prospective, concurrent, and retrospective reviews across inpatient, outpatient, ambulatory, and ancillary services to verify medical necessity, appropriate length of stay, intensity of service, and level of care.

Responsibilities include establishing care plans and coordinating care along the health care continuum, including member outreach assessments, to support

Qualifications

• Bachelor’s degree in nursing, allied health, business, or related field preferred.
• 2–4 years of clinical experience including acute care, discharge planning, case management, and utilization review preferred.
• Registered Nurse with current unrestricted state license (Michigan) preferred.
• Case Management certification may be preferred depending on department assignment.

Responsibilities

• Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service and level of care.
• May establish care plans and coordinate care through the health care continuum including member outreach assessments.

Skills

Clinical nursing experience

Care coordination

Utilization review

Health insurance knowledge

Education

BSN or related field

Job description

Iconma Portal is seeking a Registered Nurse-Review Analyst for a remote position with a Health Insurance client. You will conduct prospective, concurrent, and retrospective reviews across inpatient, outpatient, ambulatory, and ancillary services to verify medical necessity, appropriate length of stay, intensity of service, and level of care.

Responsibilities include establishing care plans and coordinating care along the health care continuum, including member outreach assessments, to support