Remote Utilization Review Nurse (TX/IL) Contract

HireOps Staffing, LLC; Chicago (IL); Remote; USD 46,597 - 66,365; Full time

Job summary

An established industry player is seeking a dedicated Registered Nurse for a remote contract position in the insurance or managed care sector. This role involves validating treatment plans and performing thorough medical reviews on claims. Candidates must possess strong communication skills to interact with physicians and members, alongside proficiency in Microsoft tools and health insurance databases. This is a fantastic opportunity for a skilled RN looking to make a significant impact in the healthcare industry while working remotely.

Qualifications

• Registered Nurse with unrestricted license and 3 years clinical experience.
• Knowledge of accreditation standards and health insurance legislation.

Responsibilities

• Perform medical review of claims for necessity and appropriateness.
• Communicate effectively with providers and members regarding determinations.

Skills

Verbal Communication

Written Communication

Organizational Skills

Prioritization Skills

Education

Registered Nurse (RN) License

Tools

Microsoft Word

Microsoft Excel

Health Insurance Databases

Job description

An established industry player is seeking a dedicated Registered Nurse for a remote contract position in the insurance or managed care sector. This role involves validating treatment plans and performing thorough medical reviews on claims. Candidates must possess strong communication skills to interact with physicians and members, alongside proficiency in Microsoft tools and health insurance databases. This is a fantastic opportunity for a skilled RN looking to make a significant impact in the healthcare industry while working remotely.