Utilization Review Nurse
The Judge Group Inc.

Job Info

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Location: REMOTE
Description:
Utilization Review LPN position available in Central: OH, IA, LA, MS, MO, GA

Position Description:

• Collect case specific member information, review and certify the medical necessity of prospective, concurrent, and retrospective units of inpatient and outpatient services.
• Review each case and determine the most appropriate services, setting in which the services should be delivered, the most cost efficient methods for care of delivery, and the need for planning subsequent care for contracted members and their eligible dependents as assigned.
• Provide clinical and managed care expertise.
• Provide first level clinical review for all inpatient and outpatient services requiring authorization for assigned client group.
• Identify and report quality of care issues.
• Answer telephone calls promptly as scheduled and as needed.
• Other duties as assigned.

Qualifications include:

• Active LPN nurse licensure
• Minimum of 1 year clinical experience in an acute care setting
• Previous Utilization Management experience preferred
• Knowledge of ICD-9 and CP coding preferred
• Considerable knowledge of principles, practices and current trends in nursing

Interested individuals, send resume to mhuggins@judge.com. Otherwise, send this to your colleagues who will. I look forward to speaking with you.

Megan Huggins

484-434-2946

Recruiter Associate

The Judge Group

Contact: mhuggins@judge.com

This job and many more are available through The Judge Group. Find us on the web at www.judge.com

This job has expired.