Maine Licensed Utilization Management RN
A company is looking for a Per Diem Utilization Management RN - National Remote. Key Responsibilities Validates and obtains authorization for procedures and patient admissions, ensuring compliance with payer requirements Conducts medical necessity reviews and collaborates with care teams to manage concurrent cases and denials Documents clinical reviews and supports the medical chart audit process to ensure accurate utilization management Required Qualifications Associate's Degree (or higher) in Nursing Current, 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 working with insurance and denials
A company is looking for a Per Diem Utilization Management RN - National Remote.
Key Responsibilities
Validates and obtains authorization for procedures and patient admissions, ensuring compliance with payer requirements
Conducts medical necessity reviews and collaborates with care teams to manage concurrent cases and denials
Documents clinical reviews and supports the medical chart audit process to ensure accurate utilization management
Required Qualifications
Associate's Degree (or higher) in Nursing
Current, 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 working with insurance and denials
