Job Summary
A company is looking for a Utilization Management Nurse RN - Remote - PST HOURS.
Key Responsibilities
- Conduct utilization management including prior authorization reviews for various care settings
- Evaluate medical appropriateness of care levels based on established guidelines
- Serve as a resource for complex issues and provide solutions to non-standard requests
Required Qualifications
- Active, unrestrictive RN license in state of residency or Compact RN License
- 3+ years of Managed Care and/or Clinical experience
- Proven basic computer skills with MS Outlook, Word, and Excel
- Weekend availability
- Must work Pacific Time Zone hours
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