Responsible for coordinating and managing in-patient and out-patient claims, the full-time Louisiana Licensed Utilization Review RN will ensure compliance with medical necessity and regulatory guidelines while working remotely. Key responsibilities Identify areas for improvement and implement solutions in collaboration with management Prepare medical documentation and make recommendations for compliance with URAC standards and regulations Interact with patients and providers to assess care needs and ensure adherence to planned interventions Required qualifications Current, unrestricted Louisiana RN license Bachelor's degree in nursing, business, or a related field preferred CPUR or CPC certification required within the first 24 months of hire Three years of direct patient care experience, including two years in managed care Knowledge of medical terminology and standardized code sets
Louisiana Licensed Utilization Review RN in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.