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.
...in the country, now is the perfect time to join our clinical team! We are actively looking to hire a Psychiatric Nurse Practitioner (PMHNP) within our Beachwood OH office who are passionate about patient care and committed to clinical excellence. Full-time Hybrid Model ....
# Develop, customize, and maintain Magento 2 websites . # Build and implement custom themes, templates, modules, and extensions . # Integrate third-party tools/APIs such as payment gateways, shipping services, CRMs, and ERPs. # Optimize websites for speed,...
Job Description Job Description At Boeing, we innovate and collaborate to make the world a better place. Were committed to fostering an environment for every teammate thats welcoming, respectful and inclusive, with great opportunity for professional growth. Find...
...days ~ Employment Type: Travel /n We're seeking talented healthcare professionals whose adventure game is as strong as/n their... ...travelers. /n Great facility in MD is looking for some help in their remote Telemetry/MedSurg unit. They are in need of a traveling nurse...
...Job Description LOCATION : KINGSTON NY SEND RESUME OR EMAIL TO : ALEXG @ SMITHARNOLD.COM VP PMHNP RECRUITMENT OR CALL (***) ***-****100% Outpatient! Open for Part Time of full time We will see new graduates! We have an exciting new opportunity to work for...