Arkansas Blue Cross and Blue Shield is seeking an experienced Utilization Management Nurse to perform clinical reviews of prior approvals, network exceptions, benefit inquiries, inpatient surgical and outpatient procedures to assess medical necessity. You will interpret evidence-based criteria and corporate guidelines to support appropriate care.
The role emphasizes collaboration with providers, documentation of decisions, and adherence to regulatory standards while promoting safe,
#J-18808-LjbffrRemote RN Utilization & Medical Necessity Reviewer in workfromhome at Unknown Company
- Typical pay
- $84,500–$135,200
For context, most registered nurses earn between $84,500–$135,200 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 onsite.