Remote Utilization Review RN – Care Management

Sentara Hospitals; United States; Teletrabalho; USD 90 000 - 136 000; Tempo integral

Vantagens oferecidas por esta oferta de emprego

Medical, Dental, Vision plans

401k/403B with Employer Match

Paid Time Off and Sick Leave

Paid Parental & Family Caregiver Leave

Tuition Assistance

Student Debt Pay Down

Life Insurance

Resumo da oferta

Sentara Health is hiring a Remote Utilization Review Registered Nurse to perform prior authorization and utilization review for inpatient and outpatient services. Candidates must reside in Virginia and hold an active Virginia RN license.

As an integrated care manager, you will review care initiatives for appropriateness, ensure compliance with criteria and regulatory requirements, and communicate pertinent clinical information in writing or verbally.

Qualificações

• RN Diploma is required; BSN preferred.
• Virginia RN license required; certification within one year for integrated care management.
• 3 years of acute care nursing experience required.
• 3 years of case management experience preferred.
• Strong verbal and written communication and critical thinking.
• Proficient in basic computer skills.

Responsabilidades

• Conduct prior authorization for inpatient and outpatient reviews.
• Perform concurrent continued stay reviews for appropriate settings.
• Ensure compliance with criteria and regulatory requirements.
• Communicate pertinent clinical information in writing or verbally.

Conhecimentos

Utilization review

Care management

Communication

Critical thinking

Formação académica

RN Diploma

BSN (preferred)

Descrição da oferta de emprego

Sentara Health is hiring a Remote Utilization Review Registered Nurse to perform prior authorization and utilization review for inpatient and outpatient services. Candidates must reside in Virginia and hold an active Virginia RN license.

As an integrated care manager, you will review care initiatives for appropriateness, ensure compliance with criteria and regulatory requirements, and communicate pertinent clinical information in writing or verbally.