Remote Otter LogoRemoteOtter

Utilization Management Nurse Reviewer - Remote

Posted 3 weeks ago
All others
Full Time
USA

Overview

The Utilization Management Nurse Reviewer plays a crucial role in healthcare systems by ensuring that medical services are used efficiently and appropriately. They review medical records, treatment plans, and patient information to determine the necessity and appropriateness of medical procedures, tests, and treatments.

In Short

  • Collaborate with healthcare providers, insurance companies, and patients
  • Assess medical necessity
  • Coordinate care
  • Conduct utilization reviews
  • Provide recommendations for care plans
  • Ensure adherence to regulations and guidelines
  • Strong clinical knowledge required
  • Critical thinking skills necessary
  • Excellent communication abilities
  • Weekend shift (Fri - Sun)

Requirements

  • Registered Nurse (RN) license
  • Experience in utilization management
  • Knowledge of healthcare regulations
  • Ability to make informed decisions
  • Strong analytical skills

Benefits

  • Flexible work schedule
  • Remote work options
  • Competitive salary
  • Health insurance
  • Professional development opportunities
Dane Street logo

Dane Street

Dane Street, LLC is a healthcare-focused organization dedicated to maintaining a robust physician panel to meet client needs. The company emphasizes the importance of individual and team contributions to ensure client satisfaction and a positive working environment. With a commitment to effective physician recruitment and network management, Dane Street operates within pre-established guidelines to negotiate costs and onboard new physicians. The organization values strong communication, negotiation skills, and a thorough understanding of medical terminology and compliance guidelines, fostering a collaborative atmosphere that supports both operational teams and physician reviewers.

Share This Job!

Save This Job!

Similar Jobs:

ProgenyHealth logo

Utilization Management Nurse - Remote

ProgenyHealth

1 week ago

ProgenyHealth is seeking a full-time Utilization Management Nurse to coordinate care for newborns in a fully remote setting.

Worldwide
Full-time
All others

M.S

Utilization Management Nurse - Remote

Morgan Stephens

7 weeks ago

Join our team as a Utilization Management Nurse, ensuring efficient patient care and compliance with regulations.

FL, USA
Full-time
All others
$75,000+/year
Wellmark logo

Utilization Management Nurse I - Remote

Wellmark

6 weeks ago

Join Wellmark as a Utilization Management Nurse to provide support and consultation to members and healthcare providers.

IA, USA
Full-time
All others
Mountain Pacific logo

Utilization Nurse Reviewer - Remote

Mountain Pacific

2 weeks ago

The Utilization Nurse Reviewer is responsible for conducting quality assurance and clinical reviews to evaluate medical necessity for services.

USA
Full-time
All others
$27.88 - $34.00/hour
Dane Street logo

Utilization Management Physician Reviewer - Remote

Dane Street

48 weeks ago

Dane Street is seeking a Physician for utilization review services in a remote capacity.

United States
Full-time
All others