Position: Concurrent Review Nurse
Client: Large Payer Client
Location: 100% Remote (Arizona time zone)
Length: 6-month Contract
Start Date: ASAP
Summary:
This position, within the Utilization Management Department, will determine the medical appropriateness of requested services by reviewing clinical information and applying evidenced-based guidelines. This position will interact with providers, members, internal and external service teams to obtain necessary information and communicate determinations. In addition to pre-service, admission, and concurrent review determinations, this position will be responsible for managing length of stay, discharge planning, resources, and identification of potential quality of care or safety concerns.
Minimum Qualifications:
- Active RN license in Arizona or a Compact/Multi-State license is required
- Experience working in inpatient setting
- Experience with MCG criteria
- Utilization Management experience preferred
- Previous payer experience is a plus
