Job description
Piper Clinical Solutions is actively seeking a Utilization Review Nurse for a totally remote position. This team works to support one of the world’s largest, most innovative healthcare providers bridge the gap between health care and medical coverage. This is a remote, Monday through Friday 8am-5pm position.
Responsibilities for the Utilization Review Nurse:
- Review medical charts and issue pre-authorizations for medical procedures based on patient needs, physician recommendations, and coverage
- Refer cases to the necessary health care providers based upon medical review findings that do not meet criteria
- Further the delivery of care across the Health Care System by coordinating between patients and health care providers
- Employ cost effective health care services based on medical necessity and contractual benefits
Qualifications for the Utilization Review Nurse:
- 3+ years of hands on hospital clinical experience including critical care, step down unit or med surg.
- Must be a Licensed Partitional Nurse or Registered Nurse in the state of North Carolina or have multi-state compact licensure
- Hands on experience with evaluating medical records and charts
- Utilization review experience strongly preferred
Compensation for the Utilization Review Nurse:
- Compensation: $30 - $37/hr. based on years in industry and relevant experience
- Full Benefits: Medical, Dental, Vision, 401k
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