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Remote New York Licensed Inpatient Utilization Management Nurse

Company: Clearlink Partners
Location: Reno
Posted on: May 4, 2021

Job Description:

A professional services firm specializing in IT, healthcare, and accounting is in need of a Remote New York Licensed Inpatient Utilization Management Nurse. Candidates will be responsible for the following: Performing concurrent reviews of inpatient and inpatient sub-acute claims Identifying solutions to problems and non-standard requests Performing prior authorization reviews for outpatient services Skills and Requirements Include: Current unencumbered RN license in New York Demonstrated knowledge of and proficiency using Milliman Care Guidelines (MCG) and/ or InterQual criteria 5+ years of acute clinical experience and 2+ years of utilization management experience Utilization management for Medicare Advantage, Managed Medicaid, Dual SNP, & Commercial Lines of Business Strong knowledge of utilization management processes, standards, and an understanding of managed care The ability to effect change, perform critical analyses, promote positive outcomes, and facilitate empowerment for members/families

Keywords: Clearlink Partners, Reno , Remote New York Licensed Inpatient Utilization Management Nurse, Executive , Reno, Nevada

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