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
- $70,000 – $90,000
- License: Compact
- 3+ years
Job description
The Utilization Management Nurse Consultant uses clinical judgment to review medical records and determine medical necessity for services using InterQual criteria. This is a 100% remote role open to nurses with an active compact RN license. Requires 3+ years acute-care experience. BSN preferred. Salary range: $70,000–$90,000 plus benefits.
Key responsibilities
- Review medical records for medical necessity using InterQual criteria
- Make coverage determinations based on clinical guidelines
- Communicate decisions to providers and members
- Escalate complex cases to medical director
What you bring
- Active compact RN license
- 3+ years acute-care experience
- Working knowledge of InterQual or MCG
- Strong clinical judgment
Tags
100% RemoteCompact RNInterQualUtilization Review
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- New3d ago
- Specialty: Utilization Review
- Job type: Full-time
- Salary: $70,000 – $100,000
- License states: Compact
100% RemoteCompact RN+2Job details - New4d ago
Appeals Nurse Consultant
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- Specialty: Utilization Review
- Job type: Full-time
- Salary: $70,000 – $100,000
- License states: Compact
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