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Telephonic Utilization Review Nurse RN

A Line Staffing Solutions

This is a Contract position in Arlington, TX posted March 8, 2022.

Concurrent Review Nurse openings with a major health insurance / managed care company in the Las Vegas NV 89128 area Starting ASAP Apply now with Luke H.

at A-Line Description of Position: Daily responsibilities : They get a hospital assigned to them They process all the inpatient authorization requests that come into the hospital Looking at new admissions and discharges, then the patients that are at the hospital They will be getting this information sent to them at home until September and then it will be an in office position Performance expectations/metrics : Turnover around time, they have 24 hours to clear the notifications once they get the authorization, Make sure that the quality and level of care is met They have internal audits and information that is given through their system Previous job titles or background that have worked well in this role : Interqual experience would be a big plus Reviewing medical records Concurrent review experience 2-4 years of experience as an RN Some sort of managed care experience, if they worked in a hospital that worked HMO type of care.

Pay Rate: $35-$42/hour Hours: Mon-Fri, 8am-5pm Required Qualifications: Registered Nurse in Nevada 2 years of experience with concurrent review and reviewing medical records Preferred Experience: Managed care experience or worked in a hospital that handled HMO type of care.

Interqual experience would be a big plus Why Apply: Full benefits available after 90 days: Medical, Dental, Vision, Life, Short-term Disability 401k after 1 year of employment: With employer match and profit sharing GREAT Hours Monday through Friday, 40 hours per week Competitive Pay Rate Keywords: Concurrent Review, Prior Authorization, Managed Care, Health Plan, Health Insurance, Case Manager, Care Manager, Utilization Review, Utilization Management, STARS, HEDIS, Complex Case Management, CCM, Certified Case Manager, NCQA, URAC, CMS, Medicare, Medicaid, HMO, RN, BSN, MSN, Registered Nurse, Quality Assurance, Quality Improvement, Medical Claims, Appeals, Denials, Utilization Review, RN, Nurse, Managed Care, Call Center, Mail Order Medications, Insurance Verification, Pharmacy, Prior Authorization, Patient Counselor, Medical Customer Service, Healthcare, Inbound Calls, Outbound Calls.

Job Requirements: Required Qualifications: Registered Nurse in Nevada 2 years of experience with concurrent review and reviewing medical records Preferred Experience: Managed care experience or worked in a hospital that handled HMO type of care.

Interqual experience would be a big plus Keywords: Concurrent Review, Prior Authorization, Managed Care, Health Plan, Health Insurance, Case Manager, Care Manager, Utilization Review, Utilization Management, STARS, HEDIS, Complex Case Management, CCM, Certified Case Manager, NCQA, URAC, CMS, Medicare, Medicaid, HMO, RN, BSN, MSN, Registered Nurse, Quality Assurance, Quality Improvement, Medical Claims, Appeals, Denials, Utilization Review, RN, Nurse, Managed Care, Call Center, Mail Order Medications, Insurance Verification, Pharmacy, Prior Authorization, Patient Counselor, Medical Customer Service, Healthcare, Inbound Calls, Outbound Calls.

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