Registered Nurse Utilization Management Reviewer

Doctor Relocation LLC

Las Vegas, Nevada, US
Base: $40.39 - $60.96 ph; bonus/equity: not specif...
Hybrid
Current registered nurse license
Bsn degree or commitment to obtain
Inpatient hospital clinical experience
The role utilizes clinical expertise to conduct utilization reviews ensuring cost-effective and medically necessary care for patients

Job Summary

  • The role utilizes clinical expertise to conduct utilization reviews ensuring cost-effective and medically necessary care for patients.
  • Employees will collaborate with providers, insurers, and families to resolve authorization queries and facilitate safe transitions of care.
  • The position offers a hybrid remote schedule with a base in Las Vegas and includes a comprehensive benefits package.

Matching Summary

The role utilizes clinical expertise to conduct utilization reviews ensuring cost-effective and medically necessary care for patients.

Salary

Base: $40.39 - $60.96 per hour; Bonus/Equity: Not specified; Benefits: Comprehensive wellness package including mind, body, and spirit programs

Skills & Requirements

Must-have

  • Current Registered Nurse license
  • BSN degree or commitment to obtain
  • Inpatient hospital clinical experience
  • Knowledge of InterQual/MCG guidelines
  • NCQA CMS regulatory compliance

Nice-to-have

  • Utilization Management experience preferred
  • Remote work environment proficiency
  • Case Management certification
  • Third party payer experience
  • Ambulatory or home care background

Key Requirements

  • Active RN license in state of practice
  • Bachelor of Science in Nursing (BSN)
  • Demonstrated inpatient nursing experience
  • Care management or utilization management background
  • Proficiency with computer hardware and multiple monitors

Work Rights

Not specified

Tailored Resume

Cover Letter