RN Utilization Review Specialist, Managed Care

Leave Your Mark; United States; On-site; USD 70,000 - 90,000; Full time

Job summary

A healthcare organization is seeking a Utilization Review Nurse to perform clinical reviews and determine the medical necessity of requested services. The ideal candidate will hold an RN license for NY and have clinical experience. Responsibilities include maintaining accurate records and providing exceptional customer service. This full-time position offers a chance to positively impact patient care within the healthcare system.

Qualifications

• Current, active and unrestricted RN license for the state of NY is required.
• 2 years of clinical experience as an RN in a varied clinical setting.
• Experience following established medical guidelines.

Responsibilities

• Perform clinical review to determine the medical necessity of requested services.
• Consult with Associate Medical Director and/or Medical Director for requests that do not meet criteria.
• Provide high quality, professional utilization management services.

Skills

RN clinical experience

Critical thinking

Time management

Proficient PC skills

Customer service

Education

Associates degree in Nursing

Bachelor's degree

Tools

MS Office

Job description

A healthcare organization is seeking a Utilization Review Nurse to perform clinical reviews and determine the medical necessity of requested services. The ideal candidate will hold an RN license for NY and have clinical experience. Responsibilities include maintaining accurate records and providing exceptional customer service. This full-time position offers a chance to positively impact patient care within the healthcare system.