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Remote Utilization Review RN

Company: Healthcare Support
Location: Virginia Beach
Posted on: November 19, 2021

Job Description:

Are you an experienced Utilization Review Nurse 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!
Daily Responsibilities:

  • Responsible to collaborate with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources.
  • Ensures medically appropriate, high quality, cost effective care through assessing the medical necessity of inpatient admissions, outpatient services, focused surgical and diagnostic procedures, out of network services, and appropriateness of treatment setting by utilizing the applicable medical policy and industry standards, accurately interpreting benefits and managed care products, and steering members to appropriate providers, programs or community resources.
    • Requires clear and active VA RN license
    • 2 years Utilization management experience with concurrent review and preservice requests
    • Knowledge of MCG criteria required
      Advantages of this Opportunity:
      • Competitive salary, negotiable based on relevant experience
      • Benefits offered, Medical, Dental, and Vision
      • Fun and positive work environment
        Hours for the Position:Shift: M-F 8-5pm
        Interested in being Considered?
        If you are interested in applying to this position, please click Apply Now for immediate consideration.
        Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.

Keywords: Healthcare Support, Virginia Beach , Remote Utilization Review RN, Healthcare , Virginia Beach, Virginia

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