Seeking a full-time remote Utilization Management RN, the successful candidate will manage medical record reviews and denial documentation, develop clinical appeal letters, and utilize clinical judgment to support healthcare provider clients. Key Responsibilities Perform detailed medical record reviews and analyze healthcare insurance denial documentation Prepare accurate and defensible clinical appeal letters based on clinical information and supporting documentation Collaborate with healthcare professionals to ensure compliance with policies and quality standards Required Qualifications Current, active Registered Nurse (RN) license 3+ years of bedside nursing experience in Adult Emergency Department, Telemetry, ICU, or CCU Strong clinical assessment and critical-thinking skills Excellent written communication and professional writing skills Proficiency with Microsoft Word and standard computer applications
Utilization Management RN in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.