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Remote Utilization Review Registered Nurse

Company: VirtualVocations
Location: Downey
Posted on: February 14, 2021

Job Description:

A global healthcare company has an open position for a Remote Utilization Review Registered Nurse . Candidates will be responsible for the following: Collecting, analyzing, and evaluating clinical documentation received using established criteria to determine appropriateness of clinical decisions Meeting/exceeding service level goals (e.g., Grade of Service, Average Handle Time, Average Speed to Answer, Abandonment Rate) Adherence to regulatory and departmental timeframes for review of requests received Must meet the following requirements for consideration: Registered Nurse with 1-3yrs. experience in a Managed Care environment. Valid Nursing License in the state of residence. Working knowledge of medical coding (CPT/ICD-10) Medical necessity criteria (e.g., InterQual, Highmark, Trail Blazer)

Keywords: VirtualVocations, Downey , Remote Utilization Review Registered Nurse, Healthcare , Downey, California

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