Utilization Management Nurse (100% remote-Oregon RN License required) ID-1674
Job Description
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Review clinical information for medical necessity determinations of provider service requests for the inpatient and outpatient services.
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Perform initial and ongoing reviews for inpatient admissions, level of care, observation, pre-service, concurrent review and discharge planning in accordance with Customer’s inpatient policy and procedures, medical policy guidelines, MCG decision support criteria and CMS regulatory requirements.
Customer Support, $50/hr, Remote, Evening/Night Job, No Degree Live Chat Support, $35/hr, Remote, No Experience Required Virtual Assistant, Remote, $50/hr, Part-Time, Night Shift Data Entry, No Degree, $40/hr, Part-Time, Remote Job Remote Data Entry, $40/hr, Part-Time, No Degree Required Virtual Assistant, $40/hr, Evening, Remote, College Student Live Chat Support, $40/hr, Weekend, Remote, No Degree Entry Level Phone Job, $42/hr, Remote, No Degree Required Data Entry, $40/hr, Evening Job, No Experience, Remote Remote Moderator, $42/hr, Weekend, No Experience Required Remote Customer Support, $35/hr, Night Shift, No Degree Remote Moderator, $42/hr, College Student, Weekend Job Virtual Assistant, $40/hr, Evening, Remote, College Student Customer Support, $42/hr, Remote, Part-Time, No Degree Remote Live Chat, $45/hr, College Student, No Experience Remote Moderator, $42/hr, Part-Time, Weekend, No Degree Virtual Assistant, No Degree, $40/hr, Remote, Part-Time Live Chat Support, $35/hr, Remote, No Experience Required Virtual Assistant, $42/hr, Evening, Remote, College Student Part-Time Customer Support, $40/hr, Remote, College Student Remote Data Entry, $45/hr, Weekend Job, College Student Remote Phone Job, $40/hr, No Degree, College Student Friendly Remote Live Chat, $35/hr, Part-Time, Evening/Night Job Virtual Assistant, $45/hr, No Experience, Remote, Night Job Remote Data Entry, $40/hr, College Student Friendly, Part-Time Virtual Assistant, $35/hr, Remote, Part-Time, Evening Job Data Entry, $35/hr, Night Shift, No Degree,?Remote?Job Virtual Assistant, $40/hr, No Experience, Remote, Night Job Remote Customer Support, $40/hr, No Degree, Evening Job Remote Phone Job, $35/hr, College Student, Night Shift Remote Moderator, $42/hr, Weekend, No Experience Required Customer Support, $40/hr, Remote, Part-Time, No Degree Remote Customer Support, $40/hr, Night Job, No Experience Remote Data Entry, $40/hr, Part-Time, College Student Job Virtual Assistant, $40/hr, Remote, No Experience, Evening Virtual Assistant, Remote, $50/hr, Part-Time, Night Shift Remote Phone Job, $45/hr, Part-Time, No Degree Required Live Chat Support, $42/hr, Weekend, Remote, No Degree Virtual Assistant, $50/hr, Evening, Remote, College Student Phone Job, $45/hr, Remote, Night Shift, No Degree Remote Data Entry, $40/hr, Weekend Job, College Student Virtual Assistant, $40/hr, Remote, Night Shift, No Experience Remote Phone Support, $45/hr, Night Job, College Student Weekend Data Entry, $40/hr, Remote, No Experience Phone Support, $45/hr, Remote, No Experience, Evening Job Remote Live Chat, $35/hr, Part-Time, Evening/Night Job Virtual Assistant, No Experience, $40/hr, Remote, Part-Time Remote Customer Support, $35/hr, Night Shift, No Degree Customer Support, $40/hr, Weekend Job, Remote, No Degree Phone Support, Remote, $50/hr, No Experience, Part-Time Remote Moderator, $45/hr, No Degree, Weekend Job, Part-Time Remote Phone Support, $40/hr, Evening, No Experience Required Live Chat Support, $40/hr, Remote, Entry Level, Part-Time Part-Time Data Entry, $45/hr, Remote, College Student Friendly Data Entry, No Experience, $50/hr, Remote, College Student Remote Customer Support, $35/hr, Night Shift, No Degree Virtual Assistant, No Degree, $45/hr, Remote, Part-Time -
Process requests for prior authorization of outpatient services in accordance with Customer’s inpatient policy and procedures, medical policy guidelines, MCG decision support criteria and CMS regulatory requirements.
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Conduct all medical necessity clinical reviews in Customer’s care management platform for full transparency and tracking of Nurse activities and performance measures.
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Participate in department meetings, training, and audit activities equal to Customer employees.
