URGENT START - Utilization Management Nurse Reviewer - $39 per Hour! REMOTE
Our Client is currently looking for hard working individuals to join their team. They are currently looking for Utilization Management Nurse Reviewer to add on their morning team. Don't wait... Apply today!
What's in it for you?
-Remote
-1st Shift
-Start ASAP
-$38 - $39 per Hour!
-11 months
-$25 Referral Bonus (T&Cs Apply)
What you will be doing?
* Performs utilization management reviews in accordance with federal and state regulations
* Maintains compliance with regulatory changes affecting utilization management
* Perform UM reviews (prospective/concurrent/retrospective) for inpatient services according to the NCQA, URAC, CMA & DOH standards and client requirements and/or policies
* Reviews UM requests for services against established clinical review criteria, referring cases not meeting criteria to a physician reviewer
What you bring to the Job?
Minimum Qualifications:
* Current Active and Unrestricted Nursing License required ( Associate Degree, Nursing Diploma or Bachelor's degree in Nursing)
* 3 years combined clinical and utilization management experience in a managed health care plan preferred
Preferred Qualifications:
* Bachelor's Degree in Nursing preferred with 3-5 years of clinical experience in Utilization Review
* Required experience in utilization management to include utilization review, concurrent review, discharge planning, transitional care and Skilled nursing review.
* Knowledge of Medicaid, Commercial or Medicare Managed Care programs and regulations
Experience & Education:
*Experience using and applying InterQual & MCG clinical guidelines
*Comprehensive understanding of standards such as NCQA, URAC, CMS (Medicare/Medicaid) and their application in a managed care setting
*Intermediate Microsoft Word, Excel, Outlook & PowerPoint skills
Why should you choose Manpower?
Free training to upgrade your skills, include a full college tuition program
Manpower customer care support
Weekly pay deposited right to your account
Interested? Call Jhon Kenneth at 414-982-1959 Ext. 7021 and email your updated resume to
[email protected] to start the hiring process.
Share this job with friends and family and earn $25 for every successful hire.
Manpower recognizes the importance of providing an accessible and barrier-free environment. We are committed to creating a welcoming fair, and inclusive environment by offering equal opportunity to access our services. At Manpower, we are committed to providing accommodations, and will work with you to meet your needs.