Utilization Review RN - Necessity Specialist (Contract)

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

Get notified about new Appeals Coordinator jobs in United States.

10,000+ Appeals Coordinator Jobs in United States

Appeals & Grievance Case Resolution Specialist

Appeals & Grievances Coordinator - Kelsey Seybold Clinic - Pearland

Appeals & Grievance Case Resolution Specialist

Dental Healthcare Analyst - Work From Home

Senior Grievance and Appeals Coordinator

Grievance and Appeals Coordinator II / Req 956599811

Appeals and Grievances Clinical Specialist/ Quality Of Care

Appeals and Grievances Clinical Specialist/ Quality Of Care

Government Programs Appeals and Grievances Research Specialist

Specialist, Admin Complaints, Grievances & Appeals

Grievance & Appeals - Grievance & Appeals Coordinator 201-1008

Appeals Specialist ( Required to live locally)

Clinical Experience & Grievances Specialist

Denials Coordinator – Hospital Billing Patient Financial Services – Corporate 42nd Street – Full-Time –Days (Hybrid)

Sr Coordinator, Complaints & Appeals Operations

Regulatory Complaint Coordinator, Intermediate

Patient Grievance and Relations Specialist