Remote Utilization Review RN – Prior Authorization

Integrated Resources, Inc ( IRI ); Illinois; Remote; USD 70,000 - 100,000; Full time

Job summary

A health care recruitment agency is seeking a Recruitment Manager to assess and analyze clinical service requests, verify member benefits, and process prior authorizations. Candidates must have an Illinois state RN license and 1-3 years of experience in hospital or medical clinic settings. This is a fully remote position, offering work within a collaborative multidisciplinary team. The role focuses on ensuring compliance with regulations and providing optimal member care.

Qualifications

• Candidates must have an Illinois state RN license.
• 1-3 years of experience in hospital or medical clinic, utilization review or prior authorization.

Responsibilities

• Assess and analyze clinical service requests using evidence-based criteria.
• Verify member benefits and eligibility.
• Process prior authorization determinations within regulatory timelines.
• Collaborate with multidisciplinary teams.

Job description

A health care recruitment agency is seeking a Recruitment Manager to assess and analyze clinical service requests, verify member benefits, and process prior authorizations. Candidates must have an Illinois state RN license and 1-3 years of experience in hospital or medical clinic settings. This is a fully remote position, offering work within a collaborative multidisciplinary team. The role focuses on ensuring compliance with regulations and providing optimal member care.