Utilization Review Nurse

w3r Consulting; Illinois; On-site; USD 70,000 - 90,000; Full time

Job summary

A healthcare staffing firm is seeking a Senior Healthcare Recruiter in Illinois. The role involves validating medical treatment plans using medically accepted criteria within insurance or managed care settings. Candidates must be a licensed RN with experience in utilization management. This is a contract position with a focus on healthcare provider roles.

Qualifications

• Required RN with IL Active License and Utilization experience.
• Familiarity with MCG and ASAM criteria is a must.

Responsibilities

• Validate medical necessity and appropriateness of treatment plans.
• Work in the context of insurance or managed care.

Skills

Utilization management

Medical necessity validation

Familiarity with MCG criteria

Familiarity with ASAM criteria

Education

RN with IL Active License

Job description

Overview

Senior Healthcare Recruiter Passionate About People ️, Dedicated to Healthcare | Senior Recruiter Building the Future of Healthcare Teams

Schedule: 8am to 5pm (M-F)

Description: RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan.

Responsibilities

• Use medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan in the context of insurance or managed care.

Qualifications

• Required: RN with IL Active License, with Utilization experience; familiar with MCG and ASAM criteria.
• Preferred: Inpatient hospital experience or ER background.

Seniority level

• Mid-Senior level

Employment type

• Contract

Job function

• Health Care Provider

Industries

• Insurance