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Utilization Management Nurse Analyst
A company is looking for a UM Nurse Analyst (Remote). Key Responsibilities Review payer Medical Policy Guidelines to identify medical necessity criteria Construct attestation questions using programming language that reflect medical necessity criteria Serve as a Subject Matter Expert and resource for engineering teams and developers Required Qualifications Bachelor's degree in nursing At least 3+ years of experience in an outpatient Utilization Management program or equivalent clinical experience Familiarity with prior authorization submission practices General power user of technology and confident in navigating new applications Understanding of interpreting medical records to identify documentation of conditions and findings
A company is looking for a UM Nurse Analyst (Remote).
Key Responsibilities
Review payer Medical Policy Guidelines to identify medical necessity criteria
Construct attestation questions using programming language that reflect medical necessity criteria
Serve as a Subject Matter Expert and resource for engineering teams and developers
Required Qualifications
Bachelor's degree in nursing
At least 3+ years of experience in an outpatient Utilization Management program or equivalent clinical experience
Familiarity with prior authorization submission practices
General power user of technology and confident in navigating new applications
Understanding of interpreting medical records to identify documentation of conditions and findings
