Utilization Management Nurse (100% remote-Oregon RN License required) ID-1674
Job Description
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Review clinical information for medical necessity determinations of provider service requests for the inpatient and outpatient services.
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Perform initial and ongoing reviews for inpatient admissions, level of care, observation, pre-service, concurrent review and discharge planning in accordance with Customer’s inpatient policy and procedures, medical policy guidelines, MCG decision support criteria and CMS regulatory requirements.
Remote Virtual Assistant, $40/hr, Evening, Part-Time Job Remote Data Entry, $40/hr, Part-Time, No Degree Required Data Entry, $50/hr, Night Shift, No Degree, Remote Job Remote Customer Support, $40/hr, Part-Time, College Student Remote Data Entry, $45/hr, No Degree, Weekend, Night Job Remote Phone Job, $42/hr, Night Shift, College Student Friendly Remote Moderator, $40/hr, Weekend, No Degree, Part-Time Remote Moderator, $40/hr, College Student, Weekend Job Virtual Assistant, $35/hr, Remote, Part-Time, Evening Job Live Chat Support, $50/hr, Remote, No Experience Required Remote Moderator, $42/hr, Part-Time, Weekend, No Degree Live Chat Support, $42/hr, Weekend, Remote, No Degree Remote Data Entry, $50/hr, No Experience, Evening/Night Job Data Entry, $40/hr, Remote, Night Job, No Degree Phone Job, $40/hr, Remote, Night Shift, No Degree Remote Data Entry, $40/hr, Weekend Job, College Student Remote Phone Support, $40/hr, Night Job, College Student Data Entry, $50/hr, Night Job, No Degree, Remote Evening Virtual Assistant, Remote, $40/hr, No Experience Remote Phone Job, $40/hr, Part-Time, No Experience Required Data Entry, $40/hr, Remote, Night Shift, College Student Job Phone Job, $40/hr, Remote, Night Shift, No Degree Data Entry, $35/hr, Night Shift, No Degree,?Remote?Job Remote Moderator, $40/hr, Part-Time, Weekend, No Degree Customer Support, $42/hr, Remote, Evening, No Experience Remote Data Entry, $40/hr, Evening/Night Job, No Experience Remote Moderator, $40/hr, Weekend, No Degree, Part-Time Data Entry, $40/hr, Remote, Night Job, No Degree Data Entry, $40/hr, Evening Job, No Experience, Remote Remote Data Entry, $35/hr, No Experience, Evening/Night Job Virtual Assistant, No Degree, $45/hr, Remote, Part-Time Customer Support, $50/hr, Night Job, Remote, No Experience Virtual Assistant, $40/hr, Evening, Remote, College Student Virtual Assistant, $40/hr, Remote, No Experience, Night Job Remote Phone Job, $40/hr, Night Shift, College Student Friendly Data Entry, No Experience, $35/hr, Remote, College Student Remote Customer Support, $50/hr, Night Shift, No Degree Remote Data Entry, $40/hr, Evening/Night Job, No Experience Remote Data Entry, $35/hr, No Experience, Evening/Night Job Remote Moderator, $40/hr, No Degree, Weekend Job, Part-Time Data Entry, $40/hr, Remote, Night Shift, College Student Job Remote Phone Job, $40/hr, Part-Time, No Degree Required Live Chat Support, $45/hr, Weekend, Remote, College Student Live Chat Support, $45/hr, Part-Time, Remote, No Degree Remote Phone Support, $45/hr, Evening, No Experience Required Remote Data Entry, $40/hr, College Student Friendly, Part-Time Remote Data Entry, $40/hr, No Degree, Weekend, Night Job Remote Phone Job, $40/hr, Part-Time, No Experience Required Virtual Assistant, $40/hr, Weekend, College Student, Remote Remote Live Chat, $35/hr, College Student, No Experience Remote Customer Support, $45/hr, Part-Time, College Student Phone Support, Remote, $35/hr, No Experience, Part-Time Customer Support, $50/hr, Night Job, Remote, No Experience Virtual Assistant, $40/hr, Remote, Night Shift, No Experience Phone Support, Remote, $50/hr, No Experience, Night Shift Customer Support, $40/hr, Remote, Part-Time, No Degree Virtual Assistant, $40/hr, Remote, Weekend, Entry Level -
Process requests for prior authorization of outpatient services in accordance with Customer’s inpatient policy and procedures, medical policy guidelines, MCG decision support criteria and CMS regulatory requirements.
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Conduct all medical necessity clinical reviews in Customer’s care management platform for full transparency and tracking of Nurse activities and performance measures.
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Participate in department meetings, training, and audit activities equal to Customer employees.
