TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective, appropriate utilization of Behavioral Health and Medical/Surgical services.
Responsibilities include preauthorization, inpatient and continued stay reviews, and presenting complex cases for Medical Director review, while staying compliant with InterQual and TriWest policies.
#J-18808-LjbffrRemote Utilization Review Nurse in workfromhome at Unknown Company
This position is listed as full time and onsite.