Clinical Guide: Um Nurse (outpatient Prior Authorization)- Remote

Devoted Com Inc

Remote
Base: $85,000-$100,000 / year; bonus/equity: bonus...
Fully remote
Weekend operations availability
Rn license
Utilization management experience
You will be responsible for providing clinical review of cases using standard criteria to determine the medical appropriateness of inpatient and outpatient services while supporting our members through assessment, care, and conservation

Job Summary

  • You will be responsible for providing clinical review of cases using standard criteria to determine the medical appropriateness of inpatient and outpatient services while supporting our members through assessment, care, and conservation.
  • Your Responsibilities and Impact will include: Performs initial, concurrent, and discharge reviews of all cases, including using medical guidelines to determine the medical appropriateness of inpatient and outpatient services.
  • Our Total Rewards package includes: Employer sponsored health, dental and vision plan with low or no premium, generous paid time off, and stock options for all employees.

Matching Summary

You will be responsible for providing clinical review of cases using standard criteria to determine the medical appropriateness of inpatient and outpatient services while supporting our members through assessment, care, and conservation.

Salary

Base: $85,000-$100,000 / year; Bonus/Equity: Bonus eligibility; Benefits: Health, dental, vision, PTO, stock options, 401K

Skills & Requirements

Must-have

  • Weekend operations availability
  • RN license
  • Utilization management experience
  • Medical guidelines
  • CMS guidelines

Nice-to-have

  • Compassionate and solutions-oriented
  • Relationship building skills
  • Adaptability in dynamic environment
  • Enthusiastic about member experience

Key Requirements

  • Unrestricted RN license
  • 4 years of RN experience
  • 3 years of utilization management experience
  • Understanding of CMS guidelines

Work Rights

Not specified

Tailored Resume

Cover Letter