Title: Utilization Review Nurse Location: Fully Remote must reside in - TX/IL Duration: 6 months Contract (Possible Extension) Schedule: Monday – Friday, 8:00 AM – 5:00 PM Pay Rate : $40/hr - $41/hr on W2 Job Description: RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan. This Position Is Responsible for Performing Accurate and Timely Medical Review of Claims Suspended for Medical Necessity, Contract Interpretation, Pricing; And to Initiate And/or Respond to Correspondence from Providers or Members Concerning Medical Determinations. Knowledge of accreditation, i.e., URAC, NCQA standards and health insurance legislation. Awareness of claims processes and claims processing systems. PC proficiency to include Microsoft Word and Excel and health insurance databases. Verbal and written communication skills with ability to communicate to physicians, members and providers and compose and explain document findings. Organizational skills and prioritization skills. :Registered Nurse (RN) with unrestricted license in state. 3 years clinical experience.aa415a4b-8b21-40fc-a65c-70d2b25ca29a
...Job Type Full-time Description We are hiring an experienced Automotive New Car Sales Director for our growing and fast-paced dealership! The right candidate MUST have a proven track record of effect management in Sales within the Automotive industry....
...Job Description CRNA Opening in Missouri Located in *Marshall, MO - 88 miles to Kansas CityShift: Full time/Permanent, Days, on-call rotation is requiredAs a non-profit community hospital, we are vital to the health and well-being of the communities it serves in...
...Department: 85043 Wake Forest University Health Sciences - Academic Public Health Sciences: Social Sciences Status: Full time Benefits Eligible... ...of the assigned project(s). This position combines research management and academic research skills. This classification...
Clean Harbors Cleveland, OH is looking for a Diesel Vehicle Mechanic to join their safety conscious team! This position will be responsible for the repairs and preventative maintenance of all company owned fleet. Why work for Clean Harbors? Health and Safety...
...Job Posting Must be a USC. We will issue a Public Trust Fairfax, VA location onsite (remote until COVID lets people go to work, but local candidates only). Requirements: Minimum Skills Required: 3+ years of experience on a software engineering team, collaborating with...