We are aggressively seeking a Utilization Review RN to join a large Healthcare organization. As the year 2018 is in full swing, this organization is very busy, and they need YOUR help.
Take advantage of a competitive salary and be a Utilization Review RN with one of the fastest-growing healthcare companies in the U.S. Get in NOW, while there is still huge room for growth and career development!
This exciting opportunity will require a Utilization Review RN who can provide a high level of service and attention to their customers. If you are a Utilization Review RN and you meet the qualifications listed below, please click apply below for consideration
This Utilization Review RN will be responsible for working with healthcare providers to help ensure appropriate and consistent administration of plan benefits.
- Conducts pre-certification, inpatient, out of network and appropriateness of treatment setting reviews within scope of licensure by utilizing appropriate medical policies and clinical guidelines in compliance with department guidelines and consistent with the members eligibility, benefits and contract.
- Develops working partnerships with physicians, healthcare service providers, and internal and external customers to help improve health outcomes for members.
- Applies clinical knowledge to work with facilities and providers for care-coordination.
- May access and consult with peer clinical reviewers, Medical Directors and/or delegated clinical reviewers to help ensure medically appropriate, quality, cost effective care throughout the medical management process.
- Must have clear and active RN license in state of FL
- Utilization Review experience (1 year min. preferred; Concurrent Review Preferred)
- Managed Care experience (1 year min. preferred)
- Understanding of Federal and State program requirements
- Must have high speed internet and landline
- Computer Proficient: Excel
Advantages of this Opportunity:
- Competitive salary
- Benefits offered, Medical, Dental, and Vision
- Growth Opportunity
- Fun and positive work environment
Interested in being considered?
If you are interested in being considered for the Utilization Review RN position, please click the Apply button below, or e-mail us directly:
Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!Healthcare Support Staffing, Inc. is an equal employment opportunity employer and will consider all qualified applicants without regard to race, color, religion, disability, sex, sexual orientation, gender identity, national origin, protected veteran status, or any other characteristic protected by applicable local, state, or federal law.
Role: Utilization Review RN
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