Compact RN Utilization Management Nurse

Job Summary

A company is looking for a Utilization Management Nurse RN - Remote.

Key Responsibilities

• Conduct prior authorization reviews for various levels of care, including skilled nursing facilities and acute inpatient rehabilitation
• Evaluate medical appropriateness of care based on guidelines and member benefits
• Act as a resource for complex issues and provide solutions to non-standard requests

Required Qualifications

• Active, unrestricted RN license in state of residency or Compact RN License
• 3+ years of Managed Care and/or Clinical experience
• Proficient in MS Outlook, Word, and Excel
• Availability to work weekends
• Must operate within the AZ Time Zone