Utilization Review Nurse (Fully Remote)

Complete medical necessity reviews and level of care reviews for requested services. Obtain necessary information via phone and fax to assess member's condition and apply guidelines. Meet required decision-making SLAs and refer members for further care engagement. Requirements: Active unrestricted RN licensure or compact multistate license. 1+ year of utilization review experience in managed care. Strong experience with MCG or InterQual. 1+ years clinical experience in acute care. Weekend availability required. Oscar fosters an inclusive environment where authenticity is valued. We offer medical, dental, vision, 401(k), paid parental leave, and more. We are an equal opportunity employer. Oscar Health Oscar Health is a technology-driven health insurance company focused on simplifying healthcare for its members. We are a mission-driven organization with a diverse team, committed to innovation and equity in healthcare. #J-18808-Ljbffr