Massachusetts Licensed RN ReviewerVirtualVocations • Omaha, Nebraska, United States
Massachusetts Licensed RN Reviewer
VirtualVocations • Omaha, Nebraska, United States
[job_card.30_days_ago]
[job_preview.job_type]
- [job_card.full_time]
[job_card.job_description]
A company is looking for an RN Utilization Management Reviewer.
Key Responsibilities :
Conduct pre-certification, concurrent, and retrospective reviews focusing on utilization management and care coordination
Evaluate members' clinical status and develop cost-effective, medically necessary plans of care
Collaborate with a team of professionals to provide high-level care coordination and monitor clinical quality concerns
Required Qualifications :
3-5 years of relevant experience in clinical health care settings
Utilization Management experience preferred
Active licensure in Massachusetts is required
Bachelor's degree in nursing (BSN) preferred for registered nurses
Ability to interpret and document complex medical information
[job_alerts.create_a_job]
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