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UM Nurse Clinical Reviewer - LPN RN Indiana

Company: VirtualVocations
Location: Costa Mesa
Posted on: July 6, 2024

Job Description:

A company is looking for a Utilization Management (UM) Nurse Clinical Reviewer - LPN/RN.

Key Responsibilities:

Perform various medical record reviews accurately and timely
Utilize clinical expertise to determine medical appropriateness
Assess workload, adjust schedules, and maintain quality monitoring activities

Required Qualifications:

Active LPN or RN license in Indiana or other applicable State/Clinical license
Graduate of an accredited Nursing Program
2+ years of UM experience in State, Hospital, or Health Plan settings
Knowledge of InterQual or MCG criteria and NCQA/URAC standards
2+ years of relevant clinical experience with strong clinical assessment and critical thinking skills

Keywords: VirtualVocations, Costa Mesa , UM Nurse Clinical Reviewer - LPN RN Indiana, Healthcare , Costa Mesa, California

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