MM
Registered Nurse - Utilization Management (Remote)
Mitchell Martin
- 🇺🇸 United States
- Remote
- 18 hours ago
- $41.15 – $46.15 / hour
- RN License
18 hours ago
Not enough detail in this posting to match
Title: Registered Nurse - Utilization Management (Remote)
Location: Philadelphia, PA (Remote)
Employment Type: Contract - Mon-Fri, Day Shift Hours
Compensation:
Pay Range: $41.15-$46.15 Per HR
Description:
• This position involves working as a Registered Nurse specializing in Utilization Management.
• The role is remote, with a requirement to reside in PA, NJ, or DE.
• It is a contract position with day shift hours from Monday to Friday.
• The role requires strong clinical judgment and experience in utilization management, along with proficiency in generic technology tools.
Requirements:
• Active, unrestricted RN license in PA or Compact states.
• Minimum of five years of clinical nursing or equivalent healthcare experience.
• Experience in utilization management or related managed care operations.
• Knowledge of clinical appeal processing and regulatory requirements.
• Strong written and verbal communication skills.
• Ability to manage competing priorities and meet deadlines.
• Proficiency with generic technology tools and systems.
Qualifications:
• BSN Preferred.
• Experience in health plan operations, including various plan types.
• Familiarity with utilization review criteria and guidelines.
• Experience with external review and complex medical necessity appeals.
• Knowledge of Medicare, Medicaid, and state-specific appeal requirements.
• Experience working with cross-functional healthcare teams.
Contact Authorization:
By applying for this job, you agree to receive AI-generated calls, text messages, and/or emails from Mitchell Martin Inc and its affiliates and contracted partners at various frequency through traditional and automated methods. Message and data rates may apply for texts. Carriers are not liable for delayed or undelivered messages. You can access our privacy policy herehttps://www.mitchellmartin.com/privacy-policy
Benefits:
Learn more about our benefits offerings herehttps://www.mitchellmartin.com/careers/benefits-perks
Onboarding Expectations:
Learn more about our Onboarding Process herehttps://youtu.be/rjV_NFYjyY4
EEO Statement:
Learn more about our EEO policy herehttps://www.mitchellmartin.com/eoe-statement
Please email:christina.impellizeri@hcmmi.com
Registered Nurse - Utilization Management (Remote) · Mitchell Martin