Clinical Utilization Review RN – Remote
RCM Health Care Services
- Riverdale, The Bronx, NY
- $95,000-110,000 per year
- Permanent
- Full-time
The Clinical Utilization Registered Nurse is responsible for collaborating with Care Management in order to support the defense of fair hearings, PCA high hour decisions, and MAP admissions.Qualifications:
Current valid New York State license as Registered Professional Nurse. Bachelor’s Degree in nursing required. Minimum of two (2) years in managed care setting, Care Management, Utilization Management and/or Grievance and Appeals experience. Demonstrated knowledge of Medicare and Medicaid regulations. Strong analytical skills. Effective oral and written communication skills. Strong organizational skills. Thorough knowledge of personal computer, especially proficiency with Microsoft Word, PowerPoint, and Excel. Ability to work and manage problems independently.Compensation: $95,000-$110,000 Annually