Maine Licensed Utilization Management RN

A company is looking for a Per Diem Utilization Management RN for a national remote position. Key Responsibilities: Validates authorization for procedure and bedded patients and ensures timely acquisition of pre-certification and continued stay authorizations Conducts medical necessity reviews and collaborates with care teams to validate information and support denials management Coordinates utilization reviews for all payers upon admission and throughout inpatient stays, ensuring compliance with Utilization Management Plan Required Qualifications: Associate's degree (or higher) in Nursing Current and unrestricted RN Compact State licensure or unrestricted RN license in state of residence and Maine 3+ years of acute clinical practice or related health care experience 1+ years of Utilization Management RN experience Experience with Cerner and InterQual, and knowledge of insurance and denials management

May 22, 2025 - 23:10

A company is looking for a Per Diem Utilization Management RN for a national remote position. Key Responsibilities: Validates authorization for procedure and bedded patients and ensures timely acquisition of pre-certification and continued stay authorizations Conducts medical necessity reviews and collaborates with care teams to validate information and support denials management Coordinates utilization reviews for all payers upon admission and throughout inpatient stays, ensuring compliance with Utilization Management Plan Required Qualifications: Associate's degree (or higher) in Nursing Current and unrestricted RN Compact State licensure or unrestricted RN license in state of residence and Maine 3+ years of acute clinical practice or related health care experience 1+ years of Utilization Management RN experience Experience with Cerner and InterQual, and knowledge of insurance and denials management