Utilization Management RN: Prior Authorization Pro

Integrated Resources Inc.; Miami (FL); On-site; USD 65,000 - 85,000; Full time

Job summary

A leading staffing firm in Miami seeks a Registered Nurse for Utilization Management. The ideal candidate will have at least 3 years of nursing experience in a critical care setting and be skilled in medical necessity reviews and authorization processes. Responsibilities include coordinating with providers, maintaining documentation, and following medical guidelines. Join a reputable team where your expertise will be valued and continue your professional growth.

Qualifications

• Registered Nurse graduated from an accredited program.
• Minimum of 3 years nursing experience, preferably in critical care.
• Familiarity with Interqual Criterion.

Responsibilities

• Completes medical necessity reviews and authorizes services.
• Interacts with providers to coordinate Utilization Management.
• Adheres to process standards and documentation requirements.

Skills

Utilization Review

Critical Care Nursing

Communication

Documentation

Education

Registered Nurse (Diploma, Associates or Bachelor's Degree)

Tools

MS Office

Job description

A leading staffing firm in Miami seeks a Registered Nurse for Utilization Management. The ideal candidate will have at least 3 years of nursing experience in a critical care setting and be skilled in medical necessity reviews and authorization processes. Responsibilities include coordinating with providers, maintaining documentation, and following medical guidelines. Join a reputable team where your expertise will be valued and continue your professional growth.