RN UTILIZATION REVIEW
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POST DATE 9/12/2016
END DATE 10/24/2016
Los Angeles, CA
JOB DESCRIPTIONThis RN UTILIZATION REVIEW Position Features:
Under the supervision of the Director of UM/Appeals assists in the administration of utilization functions, the UR Nurse will assess patient insurance/statuses to facilitate completion of utilization review.
Knowledge of payer specific criteria; such as Interqual and Milliman to determine medical necessity of care and observation. Also, serves as communication liaison between RN's, MD's and social workers, on-site reviewers, patient financial services, outpatient areas and registration; other duties as assigned to promote excellent patient care.
BS in Nursing is required
Must have 3 to 5 years of experience in the industry as a clinical nurse.
Computer skills a must including MS Word/Excel
Insurance/payer experience preferred/prior utilization review experience
If you have these specific qualifications - and would love to work for a dynamic company that continues to expand, apply for this position today! We are an equal employment opportunity employer and will consider all qualified candidates without regard to disability or protected veteran status.