Utilization Review Nurse(Austin/Richardson TX) (Remote)

<p style="margin-bottom:0in;line-height:normal;background:white;"><strong>***REMOTE - Candidates must be based in Texas:  Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties***</strong></p><p style="margin-bottom:0in;line-height:normal;background:white;"><strong> </strong></p><p style="margin-bottom:0in;line-height:normal;background:white;"><strong>JOB DESCRIPTION:</strong></p><p style=" line-height:normal;background:white;">RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan.</p><p style=" line-height:normal;background:white;"><strong>JOB RESPONSIBILITIES:</strong></p><ul><li>This position is responsible for performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness, and quality of medical/surgical services, and serving as liaison between providers and medical and network management divisions.</li><li>Collects clinical and non-clinical data.</li><li>Verifies eligibility.</li><li>Determines benefit levels in accordance to contract guidelines.</li><li>Provides information regarding utilization management requirements and operational procedures to members, providers, and facilities.</li></ul><p style="margin-bottom:0in;line-height:normal;background:white;"><strong>JOB QUALIFICATIONS (Required):</strong></p><ul type="disc"><li style="color:black;line-height:normal; background:white;">Registered Nurse (RN) with a valid, current, unrestricted license in the state of operations.</li><li style="color:black;line-height:normal; background:white;">3 years of clinical experience in a Physician's office, Hospital/Surgical setting, or Health Care Insurance Company.</li><li style="color:black;line-height:normal; background:white;">Knowledge of medical terminology and procedures.</li><li style="color:black;line-height:normal; background:white;">Verbal and written communication skills.</li></ul><div><br></div><div><strong>JOB QUALIFICATIONS (Preferred):</strong><br><br></div><ul><li>MCG or InterQual experience</li><li>Utilization management experience</li></ul><p style="margin-bottom:0in;line-height:normal;background:white;"><br></p><p style="margin-bottom:0in;line-height:normal;background:white;"><strong>LOCATION:</strong> REMOTE in Texas (Austin area – Travis/Williamson Counties or Richardson area – Dallas/Collin Counties).</p><p style="margin-bottom:0in;line-height:normal;background:white;"><strong>POSITION:</strong> 6-month assignment </p><p style="margin-bottom:0in;line-height:normal;background:white;"><strong>SALARY:</strong> $38 - $40 hourly</p><p style="margin-bottom:0in;line-height:normal;background:white;"><strong>HOURS PER WEEK:</strong> 40</p><p style="margin-bottom:0in;line-height:normal;background:white;"><strong>HOURS PER DAY:</strong> 8</p>

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