Utilization Review Nurse | Remote | Contract
Utilization Review Nurse | Remote | Contract
Walker Healthforce is seeking a Utilization Review Nurse for a healthcare client located remotely. This is a contract opportunity.
Start Date: ASAP
Walker Healthforce Standard Perks:
Weekly pay via Direct Deposit
Medical, Dental, and Vision Available
401K
JOB DESCRIPTION
RN experience in the insurance or managed care industry.
Use medically accepted criteria to validate the medical necessity and appropriateness of treatment plans.
Perform accurate and timely medical review of claims for medical necessity, contract interpretation, and pricing.
Initiate and respond to correspondence from providers or members concerning medical determinations.
JOB REQUIREMENTS
Knowledge of accreditation, i.e. URAC, NCQA standards and health insurance legislation.
Active RN license (unrestricted in the state of residence).
3+ years of clinical experience in a healthcare setting.
Experience in managed care or health insurance industry preferred.
Proficiency in Microsoft Word, Excel, and health insurance databases.
PREFERRED JOB REQUIREMENTS
Utilization Review Certification
Contact our Recruiting Team today to experience the Walker Healthforce difference!
ABOUT US
Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we're custom not commodity and we've been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today!
We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status.
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