NURSE I, II, or III - Salt Lake City - Utah Retirement Systems

    Utah Retirement Systems
    Utah Retirement Systems Salt Lake City

    14 hours ago

    Description

    About the Job


    This is an entry-level nursing position that involves identifying and coordinating the healthcare needs of PEHP members within various programs and departments.


    Key Responsibilities



    • Identify and perform utilization review of selected cases.

    • (Verify medical diagnosis,
      staus of current condition(s),
      aspecific needs/treatment plan by reviewing theelectronicmedical record,
      past claims history todetermine informationthat may affectthe current treatment plan)
    • Assist adjusters(if necessary)
      to match authorizedservicesand negotiatedfeeswith thereceivedclaims

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