Florida Licensed Utilization Management RN

A company is looking for a LTSS Utilization Management RN - Remote. Key Responsibilities Perform utilization management and determine medical necessity for in-home LTC services Provide critical analysis of case manager UM submissions and prepare documentation for Medical Director review Act as a resource for others, coaching and guiding less experienced staff Required Qualifications Unrestricted RN license in state of residence 1+ years of managed care and/or clinical experience, preferably in Medicaid and Utilization Management 1+ years of Medicaid Utilization Management experience 1+ years of experience with Microsoft Office (Word, Excel, PowerPoint) 1+ years of experience navigating in a Windows environment

May 13, 2025 - 01:17
 0
Florida Licensed Utilization Management RN
A company is looking for a LTSS Utilization Management RN - Remote. Key Responsibilities Perform utilization management and determine medical necessity for in-home LTC services Provide critical analysis of case manager UM submissions and prepare documentation for Medical Director review Act as a resource for others, coaching and guiding less experienced staff Required Qualifications Unrestricted RN license in state of residence 1+ years of managed care and/or clinical experience, preferably in Medicaid and Utilization Management 1+ years of Medicaid Utilization Management experience 1+ years of experience with Microsoft Office (Word, Excel, PowerPoint) 1+ years of experience navigating in a Windows environment