Advocating for patients through appeals, the full-time Missouri Licensed Clinical Appeals RN will work remotely to manage infusion denial cases, collaborating with an interdisciplinary team to enhance patient satisfaction and ensure appropriate care levels. Key responsibilities Utilize clinical and analytical skills to review diagnostic test results for appropriateness of care Apply Interqual Criteria to assess the level of care for elective inpatient hospitalizations Educate medical providers on the effective use of healthcare resources and cost management Required qualifications Current RN license in Missouri Minimum of 1 year of experience in Utilization Review, Case Management, or Clinical Appeals Nursing Diploma or Associate's Degree in Nursing 2-5 years of nursing experience Ability to work Monday through Friday, 8am-5pm
Missouri Licensed Clinical Appeals RN in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.