Utilization Review Registered ( Nurse RN 3)

Nurse RN 3
Remote in California
08:00:AM - 4:30 0r 5pm
Monday through Friday.
Contract to Hire/ Temp to Perm depending on the business needs
6+ months

Summary:

• Reviewing for medical Necessity all levels of care combining clinical knowledge and judgement with MCG guidelines.
• Rendering decisions and or upleveling to our in-house MD for review if the nurse is unable to approve.
• All of this to be done within regulatory turn around times.
• Our staff do not interact with members but work with the case managers and medical staff at the facilities.

Required skills:
Strong Clinical (hands on) background
Strong Computer skills
Ability to work remote/self-directed

Education/Experience:
•BSN preferred but not required
• Nursing license required.

 
 
At SPECTRAFORCE, we are committed to maintaining a workplace that ensures fair compensation and wage transparency in adherence with all applicable state and local laws. This position’s starting pay is: $ 40.00/hr.