Job Responsibilities : Nurse, Utilization Review Services – REMOTE
Salary : $16 per hour
Company : Exela Technologies Inc.
Location : Remote US
1) – Applying criteria to inpatient admissions and performing concurrent review functions identifying discharge planning needs and referrals to case management.
2) – Evaluates clinical information submitted by providers against plan review criteria and benefit guidelines
3) – Utilizes clinical information to determine if criteria for medical necessity and benefit guidelines are met
4) – Documents all pertinent case information and dispositions for approvals and denials
5) – Communicates with providers to initiate/coordinate outpatient services/discharge planning needs for members
6) – Acts as a liaison to assure services are provided in the least restrictive most cost effective and clinically appropriate setting
- Excellent hourly compensation
- Computer with dual monitors
- Full benefits including health dental vision STD LTD 401(k) and more
- Referral bonuses