A company is looking for a Utilization Review Nurse - LPN (Remote).
Key Responsibilities:
Conduct concurrent and continued stay Utilization Management reviews, ensuring accurate data tracking, evaluation, and reporting
Lead or participate actively in process improvement initiatives, collaborating with various departments and multi-disciplinary teams
Efficiently manage a diverse workload in a fast-paced, ever-evolving regulatory environment
Required Qualifications:
Current PN Nurse license
Associate?s degree preferred
2 years of Utilization Management experience in a large health organization
Hospital case management experience is advantageous
Proficiency in federal and state regulations (DOH, Medicaid/Medicare) and familiarity with third-party payers and managed care principles
