New3d ago
- Specialty: Utilization Review
- Job type: Full-time
- Salary: $75,000 – $95,000
- License states: Compact
Weekend shiftAppeals+2
Job details- Utilization Review
- Full-time
- License: Compact
- 3+ years
Job description
The Utilization Management Clinical Consultant uses clinical judgment to determine medical necessity for prior authorization requests using MCG criteria. This is a 100% remote role open to nurses with an active compact RN license. Requires 3+ years acute-care experience. BSN preferred.
Key responsibilities
- Apply MCG criteria to prior-auth requests
- Render coverage determinations within SLA
- Escalate complex cases to medical director
What you bring
- Active compact RN license
- 3+ years acute-care experience
- Working knowledge of MCG or InterQual
Tags
100% RemoteCompact RNMCG
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- License states: Compact
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