Utilization Management Nurse (100% remote-Oregon RN License required) id-10336
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.
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Remote Phone Job, $45/hr, Part-Time, No Degree Required
Remote Customer Support, $45/hr, Part-Time, College Student
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Data Entry, $45/hr, Remote, Night Job, No Degree
Live Chat Support, $40/hr, Part-Time, Remote, No Degree
Remote Live Chat, $40/hr, Part-Time, No Degree Required
Virtual Assistant, $40/hr, Remote, No Degree, Night Job
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Remote Data Entry, $40/hr, Part-Time, No Degree Required
Phone Job, $40/hr, Remote, Night Shift, No Degree
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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.
Address
Campbell Healthcare Solutions
Myrtle Point, OR97458 USA
Industry
Healthcare
Posted date
Over a month ago
