RN Care Review Clinician – Utilization & Prior Auth

Uloop Inc.; Miami (FL); On-site; USD 36,382 - 85,121; Full time

Benefits offered by this job

Competitive benefits package

Job summary

Uloop Inc. is looking for a Clinical Reviewer in Miami, Florida, to provide support for clinical member services review assessment processes. Responsibilities include assessing services, analyzing clinical requests, and ensuring compliance with guidelines.

The ideal candidate will be a Registered Nurse with an active license and at least 2 years of relevant experience. The position offers a competitive hourly pay range between $26.41 and $61.79, depending on experience and location.

Qualifications

• Registered Nurse (RN) with an active and unrestricted license.
• At least 2 years of experience in hospital acute care or similar.
• Proficiency in Microsoft Office suite.

Responsibilities

• Assesses services for members to ensure optimum outcomes.
• Anlyzes clinical service requests against evidence-based guidelines.
• Conducts reviews to determine prior authorization/financial responsibility.

Skills

Organizational skills

Problem-solving skills

Critical thinking

Communication skills

Microsoft Office proficiency

Education

Registered Nurse (RN) license

2 years of experience in healthcare

Job description

Uloop Inc. is looking for a Clinical Reviewer in Miami, Florida, to provide support for clinical member services review assessment processes. Responsibilities include assessing services, analyzing clinical requests, and ensuring compliance with guidelines.

The ideal candidate will be a Registered Nurse with an active license and at least 2 years of relevant experience. The position offers a competitive hourly pay range between $26.41 and $61.79, depending on experience and location.