Utilization Review RN
Reference Code: 5626
Utilization Review RN
Location: Oak Brook, IL 60523
Job Type: Contract
Duration: 6 months, possibility of extension
Pay Rate: $35.00/hour
Our client, a Fortune 500 multi-state healthcare organization, is looking to hire a Utilization Review RN who will work with the Utilization Management team primarily responsible for inpatient medical necessity/utilization review and other utilization management activities aimed at providing members with the right care at the right place at the right time.
This role will be providing daily review and evaluation of members that require hospitalization and/or procedures providing prior authorizations and/or concurrent review and assessing services for members to ensure optimum outcomes, cost effectiveness and compliance with all state and federal regulations and guidelines.
- The Utilization Review RN role is 100% remote and the contractor can be anywhere in the US.
- Shift: 8am-5pm CST, some weekend and holidays will be required.
- DAY-TO-DAY: Inpatient Authorizations, reviewing faxes that can be 50-100 pages long. Will be expected to manage 25-30 cases successfully daily. Should be able to quickly and accurately determine whether the criteria meets medical necessity.
- The Utilization Review RN must have an active, unrestricted Illinois RN license.
- The Utilization Review RN must have experience working in acute care/medical surgical
- The Utilization Review RN's area of expertise should be specific to inpatient reviews and must have solid experience within a clinical setting as they will need to be able to use their knowledge to extrapolate key information during the authorization process.
For more information, please call our Recruiter directly at (847)278-8615. To submit your application, click on the 'Apply for Job' link below or send your resume directly to email@example.com.
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