Job Responsibilities : Utilization Review Nurse – REMOTE
Salary : $72000 per year
Company : Exela Technologies Inc.
Location : Remote US
1) Applying criteria to inpatient admissions and performing concurrent review functions, identifying discharge planning needs and referrals to case management.
2) Evaluates clinical information submitted by providers against plan review criteria and benefit guidelines
3) Utilizes clinical information to determine if criteria for medical necessity and benefit guidelines are met
4) Documents all pertinent case information and dispositions for approvals and denials
5) Communicates with providers to initiate/coordinate outpatient services/discharge planning needs for members
6) Acts as a liaison to assure services are provided in the least restrictive, most cost effective and clinically appropriate setting
Excellent hourly compensation
Computer with dual monitors
Full benefits, including health, dental, vision, STD, LTD, 401(k), and more