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eNLC Licensed Clinical Nurse
A company is looking for a Utilization Management - Clinical Nurse to work from home. Key Responsibilities Analyze clinical information and treatment plans for authorization requests Conduct telephonic and concurrent reviews of hospitalizations and outpatient treatments Ensure compliance with regulatory standards and timely processing of denial determinations Required Qualifications RN license in an eNLC state with multistate privileges 3+ years of nursing experience 1+ years of utilization management experience Familiarity with medical terminology and clinical documentation standards Proficiency in Microsoft Office and experience with healthcare systems
A company is looking for a Utilization Management - Clinical Nurse to work from home.
Key Responsibilities
Analyze clinical information and treatment plans for authorization requests
Conduct telephonic and concurrent reviews of hospitalizations and outpatient treatments
Ensure compliance with regulatory standards and timely processing of denial determinations
Required Qualifications
RN license in an eNLC state with multistate privileges
3+ years of nursing experience
1+ years of utilization management experience
Familiarity with medical terminology and clinical documentation standards
Proficiency in Microsoft Office and experience with healthcare systems
