To provide timely, evidence-based utilization review services, the full-time Ohio Licensed RN Utilization Review will analyze treatment plan requests, obtain medical records, and collaborate with healthcare providers while working remotely. Key responsibilities Identifies and analyzes treatment plan requests and supporting medical records Utilizes evidence-based criteria to make utilization review determinations and negotiates with providers as necessary Documents outcomes in utilization review software and communicates with claim examiners to resolve clinical issues Required qualifications Active unrestricted RN license in a state or territory of the United States Associate degree from an accredited college or university; Bachelor's degree preferred Four years of related experience, including two years of recent clinical practice or one year of recent utilization review Utilization review-based certification preferred
Ohio Licensed RN Utilization Review in workfromhome at Unknown Company
- Typical pay
- $84,500–$129,531
For context, most registered nurses earn between $84,500–$129,531 a year according to Bureau of Labor Statistics wage data. What this particular role pays is set by the employer — check the description above.
This position is listed as full time and able to be worked remotely.