Nebraska Licensed Utilization Nurse in Guttenberg, NJ
Job Description
A company is looking for a Utilization Management Nurse.
Key Responsibilities
Conduct clinical claim certification and authorization reviews to assess medical necessity of services
Educate providers on member benefits and utilization management processes
Facilitate transitions of care and coordinate discharge planning with providers
Required Qualifications
Associate's degree in nursing
Three years of clinical practice experience in a healthcare setting
Current, unrestricted Registered Nurse license from Nebraska or a participating state
Experience in Medicare Advantage and Managed Care organizations
Experience in discharge planning, utilization management, or case management
Key Responsibilities
Conduct clinical claim certification and authorization reviews to assess medical necessity of services
Educate providers on member benefits and utilization management processes
Facilitate transitions of care and coordinate discharge planning with providers
Required Qualifications
Associate's degree in nursing
Three years of clinical practice experience in a healthcare setting
Current, unrestricted Registered Nurse license from Nebraska or a participating state
Experience in Medicare Advantage and Managed Care organizations
Experience in discharge planning, utilization management, or case management
Job Details
Medical Speciality
Home Health
Employment Type
Full-time
Required License
RN (Registered Nurse)
Work Setting
HospitalClinicTelehealth
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