Georgia Licensed Utilization Review Nurse
A company is looking for a Utilization Review Nurse - LPN (Remote). Key Responsibilities Conduct concurrent and continued stay Utilization Management reviews, ensuring accurate data tracking, evaluation, and reporting Lead or participate actively in process improvement initiatives, collaborating with various departments and multi-disciplinary teams Efficiently manage a diverse workload in a fast-paced, ever-evolving regulatory environment Required Qualifications Current PN Nurse license Associate's degree preferred 2 years of Utilization Management experience in a large health organization Hospital case management experience is advantageous Proficiency in federal and state regulations (DOH, Medicaid/Medicare) and familiarity with third-party payers and managed care principles
A company is looking for a Utilization Review Nurse - LPN (Remote).
Key Responsibilities
Conduct concurrent and continued stay Utilization Management reviews, ensuring accurate data tracking, evaluation, and reporting
Lead or participate actively in process improvement initiatives, collaborating with various departments and multi-disciplinary teams
Efficiently manage a diverse workload in a fast-paced, ever-evolving regulatory environment
Required Qualifications
Current PN Nurse license
Associate's degree preferred
2 years of Utilization Management experience in a large health organization
Hospital case management experience is advantageous
Proficiency in federal and state regulations (DOH, Medicaid/Medicare) and familiarity with third-party payers and managed care principles
