Join Our Team as a Utilization Management Nurse!
Experience Required:
- Five years inpatient clinical nursing experience in an acute care hospital setting
- Minimum of two years Utilization Management acute care setting experience
- Minimum of one year drafting and submitting reconsiderations and appeals to Medicare
- Preferably a minimum of two-year InterQual or Milliman experience in an acute care setting
- Bilingual preferred
Shift Details:
- Monday-Friday, flexible start/end times (7a-3p, 8-4, or 9-5)
Benefits:
- Medical coverage for employees and eligible family members
- Comprehensive dental plan including implants and child orthodontia
- Health Spending Account (HSA) with company contributions
- Life Insurance & Accidental Death & Dismemberment Insurance
- Supplemental Life Insurance at competitive rates
- Short-term & Long-term Disability coverage
- Accidental Injury & Critical Illness coverage
- 401(k) and Roth IRA Retirement Plan with generous match
- Paid Time Off and Employee Illness Bank
- Additional offerings include tuition reimbursement, free continuing education, free parking, free employee health visits, life assistance program, credit union membership, and fitness program
Day-to-Day Responsibilities:
- Provide precertification of inpatient hospitalizations and outpatient procedures
- Conduct telephonic and/or concurrent review of inpatient hospitalizations and outpatient services
- Utilize clinical judgment, utilization management, and regulatory understanding to verify medical necessity
Pay Details: $85,000.00 to $90,000.00 per hour
Equal Opportunity Employer/Veterans/Disabled
To read our Candidate Privacy Information Statement, which explains how we will use your information, please navigate to https://www.adeccousa.com/candidate-privacy
The Company will consider qualified applicants with arrest and conviction records subject to federal contractor requirements and/or security clearance requirements.