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    Remote Utilization Management Nurse - Durham, United States - Piper Companies

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    Description

    Piper Companies is currently seeking a Remote Utilization Management Nurse for a remote opportunity within a health insurance organization. The Remote Utilization Management Nurse will be serving as an essential bridge between health care and medical coverage.

    Responsibilities of the Remote Utilization Management Nurse:

    • Responsible for performing medical reviews to assess, and coordinate quality care for patients
    • Determine medical necessity utilizing MCG criteria and medical policy/contractual benefits.
    • Coordinate with patients and providers to produce high quality care
    Qualifications of the Remote Utilization Management Nurse:
    • RN or LPN- North Carolina license
    • 3 + years of clinical experience, inpatient, ER/emergency clinical experience
    • Case Management experience
    • Utilization Management experience
    Compensation for the Remote Utilization Management Nurse:
    • Annual Salary Range: $76,000-$79,000
    • Comprehensive Benefits: Medical, Dental, Vision, 401k
    Skills: RN, LPN, registered nurse, ER, Inpatient, emergency room, case management, CM, Care Management, Case Manager, utilization management, UM, MCG, Medical Necessity

    #LI-REMOTE


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