Wisconsin Licensed Utilization Review Specialist

Job Summary

A company is looking for a Utilization Review Specialist (Remote Option in Wisconsin).

Key Responsibilities

• Provide quality assurance of medical care and perform quality control related to patient treatment
• Ensure clinical roles are adequately provided for patients' comfort, health, and safety
• Analyze current environments and synthesize information for process improvement

Required Qualifications, Training, and Education

• Graduate from an accredited practical nursing program as a Licensed Practical Nurse (LPN)
• Five years of experience in a clinical setting, with preference for utilization or CPT/ICD knowledge
• Currently holds an unencumbered LPN license with State Nursing board or possesses multi-state licensure privileges
• Knowledge of quality management methods and ability to support an environment that meets quality goals
• Understanding of the Health Insurance Portability and Accountability Act (HIPAA) and its implications for patient care