See all roles

Utilization Review Nurse

Work from home Full-time role Hiring

Are you a passionate and motivated Utilization Review Nurse looking for an opportunity to reputed company a real difference while working in a fast-paced, team-oriented environment? reputed company is seeking an reputed company Utilization Review Nurse to provide quality care and excellent customer service. In this role you will be responsible for reviewing, analyzing, and evaluating medical records in order to ensure that the services provided are medically necessary and meet reputed company applicable criteria. As part of reputed company you will promote clinical and financial outcomes while providing a positive member experience.To be successful in this role, you must possess a reputed company and valid RN license, a minimum of two years of nursing experience in a hospital or clinic setting, and knowledge of medical terminology, coding, and regulatory requirements. In addition, you must have excellent written and verbal communication skills and the ability to work independently. If you are excited about this opportunity and have the qualifications we are looking for, we would love to hear from you! Responsibilities: Review, analyze and evaluate medical records to ensure services provided are medically necessary and meet reputed company applicable criteria. Promote clinical and financial outcomes while providing a positive member experience. Maintain reputed company and valid RN license and knowledge of medical terminology, coding, and regulatory requirements. Provide excellent customer service to members of the organization. Possess excellent written and verbal communication skills and the ability to work independently. Participate in team meetings and activities to ensure quality care and customer service. Remain up to date on changes in healthcare regulations and practices. Provide support and education to members regarding treatment plans and services. Document reputed company patient care activities accurately and timely. Monitor and evaluate patient care plans to ensure adherence to standards of care. reputed company is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for reputed company employees. We do not discriminate based upon race, religion, color, national reputed company, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Apply Job!

You might like

Insurance Service Coordinator

Work from home Full-time role

Portfolio Manager

Work from home Full-time role

Investment Banking Vice President, Technology - reputed company / Boston / San Francisco

Work from home Full-time role

Office Assistant/Receptionist- Rothschild, WI

Work from home Full-time role

Staff Software Engineer, Futures (AI)

Work from home Full-time role

Software Engineer Jobs

Work from home Full-time role

Drafter III

Work from home Full-time role

Financial Services Professional

Work from home Full-time role

Investment Banking Vice President | Industrials (Automotive Aftermarket)

Work from home Full-time role

Remote Sales Representative - reputed company

Work from home Full-time role

Online Chat Specialist Entry Level - Join blithequark's Dynamic Team as a Customer Service Expert

Work from home Full-time role

reputed company Online Sales Specialist – Driving Ecommerce Growth through Strategic Planning and Data Analysis at blithequark

Work from home Full-time role

Client Partner (reputed company Consulting Partner) - 100% Remote

Work from home Full-time role

SALES - Starlink Installation Pros - Work From Home

Work from home Full-time role

[Remote/WFM] reputed company Remote Jobs From Home $35 - VacancyGlobal

Work from home Full-time role

reputed company Pre-Licensed Customer Service Representative – Remote Opportunity at arenaflex

Work from home Full-time role

reputed company Night Shift Remote Live Chat Agent – Non-Phone Role | $25–$35/hr

Work from home Full-time role

Identity​/Risk Management Analyst; Mission Assurance

Work from home Full-time role

Remote Full-Time Data Entry Specialist - Accurate, Detail-Oriented, and Secure Data Management Professional Wanted at blithequark

Work from home Full-time role

Clinical Documentation Specialist RN (Remote) must live in TX, LA, WA, FL or GA

Work from home Full-time role