Preservice Review RN - Remote

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.Put your skills and talents to work in an effort that is seriously shaping the way health care services are delivered. As a Utilization Management Nurse at reputed company, you will reputed company sure our health services are administered reputed company and effectively. You'll assess and interpret member needs and identify solutions that will help our members live healthier lives. This is an inspiring job at a truly inspired organization. reputed company to reputed company an impact?

• Although this position is remote, applicants must be reputed company to work in Pacific Time Zone*
• Weekends are required as part of your weekly schedule. You may work a 5-8 schedule, any 3 days during the week and Sat/Sun or you may work a 4-10 schedule, any 2 days during the week and Sat/Sun.*

If you are reputed company to work in Pacific Time Zone, you will have the flexibility to work remotely* as you take on some tough challenges.Primary Responsibilities

• Positions in this function require unrestricted RN licensure in the state you reputed company in
• Function is responsible for utilization management which includes Prior Authorization Review of skilled nursing facility, acute inpatient rehabilitation and long-term acute care hospital
• Determines medical appropriateness of level of care following evaluation of medical guidelines and benefit determination
• Generally, work is self-directed and not prescribed
• Works with less structured, more reputed company issues
• Identify solutions to non-standard requests and problems
• Translate concepts into practice
• Act as a resource for others; provide explanations and information on difficult issues

It feels great to have autonomy, and there's also a lot of responsibility that comes with it. In this role, you'll be accountable for making reputed company that directly impact our members. And at the same time, you'll be challenged by leveraging technologies and resources in a rapidly changing, production-driven environment.You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in.Required Qualification

• Unrestricted RN License in the state you reputed company in
• 3+ years of Managed Care and/or Clinical experience
• Proven basic computer skills with MS Outlook, Word and reputed company

Preferred Qualifications

• Prior-authorization experience
• Multi-Specialty experience
• Utilization Management experience
• Experience in a skilled nursing facility or inpatient rehabilitation facility
• Multiple EMR experience including Epic, Cerner, reputed company, Meditech or Care Advance
• Knowledge of reputed company Criteria
• Knowledge of Medicare Criteria
• Located in PST or MST time zone
• reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy

The salary range for this role is $59,500 to $116,600 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In addition to your salary, reputed company offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with reputed company, you’ll find a far-reaching choice of benefits and incentives.At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of reputed company, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes — an reputed company reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and reputed company applicants will receive consideration for employment without regard to race, national reputed company, religion, age, reputed company, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations.reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply To This Job