Utilization Review Nurse - LPN (Remote)

Work with a team of bright and motivated people as a Utilization Review Nurse - LPN! We have an opening at our office in Remote. This position requires a strong and diverse skillset in relevant areas to drive success. This straightforward role comes with a dependable salary of a competitive salary.

 

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Job Summary: As a Utilization Management Nurse, you'll play a crucial role in our multidisciplinary team, ensuring that patients progress seamlessly through their care journey according to appropriate admission statuses. Proficient in Utilization Review processes, you'll maintain effective procedures to meet regulatory and reimbursement requirements for various payers, both commercial and government. 100% Remote - However, Only candidates on EST Time Zone are considered. Key Responsibilities: • Conduct concurrent and continued stay Utilization Management reviews, ensuring accurate data tracking, evaluation, and reporting. • Lead or participate actively in process improvement initiatives, collaborating with various departments and multi-disciplinary teams. • Efficiently manage a diverse workload in a fast-paced, ever-evolving regulatory environment. • Foster positive collaboration with the Care team to facilitate timely patient progression during their stay. Job Requirements: • Current PN Nurse license • Associate's degree preferred. • 2 years of Utilization Management experience in large health organization. • Hospital case management experience is advantageous. • Proficiency in federal and state regulations (DOH, Medicaid/Medicare) and familiarity with third-party payers and managed care principles. Salary Range:$75,000+ Benefits: Yes- Full benefit package available with employer contribution. Join our dynamic team and be part of our commitment to efficient Utilization Management and patient-focused care. Date of Original Job Posting: 1/25/25 Apply Job!

 

We Encourage You to Apply!

Even if you feel you're not a perfect match, we'd still love to hear from you. We are looking for great people to join our friendly team.