Utilization Management Registered Nurse (RN) - Remote

guidehealth · Remote

Posted: 54 days ago
Last confirmed live: 1 day ago

What this role involves

This role involves performing utilization review for healthcare services, including precertification and concurrent reviews, using approved medical necessity criteria. The nurse collaborates with providers, medical directors, and internal teams to ensure compliant and timely determinations. Requires an active Illinois RN license and three years of healthcare experience.

Skills this posting asks for

registered nurse
illinois state license
utilization review
managed care
community health
microsoft 365
organizational skills
writing skills
speaking skills
clinical judgment
informatics

Requirements

3 years of experience
Level: mid
Remote policy: remote

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