Utilization Review RN
Are you an experienced Utilization Review RN looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered "yes" to any of these questions - this is the position for you!
- As a Utilization Review RN, you will be responsible to collaborate with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources.
- You will work with medical directors in interpreting appropriateness of care and accurate claims payment. May also manage appeals for services denied.
- Conduct pre-certification, continued stay review, care coordination, or discharge planning for appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts.
- You will also insure member access to medical necessary, quality healthcare in a cost effective setting according to contract.
Hours for this Position:
- M-F 8:30am-5pm
- Clear and active RN license in the state of OH
- 2 years of acute clinical care experience
- Experience working with Milliman care guidelines
- Must have UM post-acute clinical experience
- Strong oral, written and interpersonal communication skills
- Good problem-solving, facilitation, and analytical skills
- Ability to work in a virtual environment
- Computer proficient: average to above average skills in MS Word, Excel, Outlook, Touch Typing, able to adapt to new software packages
Advantages of the Utilization Review RN opportunity:
- Competitive pay $29-34/hour
- Benefits offered, Medical, Dental, and Vision
- Fun and positive work environment
Interested in being considered? If you are interested in being considered for this Utilization Review RN role, please click the apply button below.
Please contact Brett Meadows firstname.lastname@example.org
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!
Wed, 31 May 2017 14:14:13 PDT