Registered Nurse UM Specialist

Job Summary

A company is looking for a PAS Nurse Author, Payor Peer to Peer.

Key Responsibilities

• Write client-facing clinical consultations evaluating authorization requests and supporting documentation
• Evaluate and interpret various hospital documentation related to authorization requests
• Provide recommendations for medical necessity arguments and conduct case reviews across multiple specialties

Qualifications & Requirements

• Prior experience in Utilization Management (UM)
• Experience with InterQual and MCG criteria
• Active registered nurse license in at least one US state
• Minimum of 3 years of acute, hospital-based clinical experience
• BSN required