Remote Utilization Management Nurse

Piper Companies is currently seeking a Remote Utilization Management Nurse for a remote opportunity within a health insurance organization. The Remote Utilization Management Nurse will be serving as an essential bridge between health care and medical coverage.

Responsibilities of the Remote Utilization Management Nurse:

• Responsible for performing medical reviews to assess, and coordinate quality care for patients

• Determine medical necessity utilizing MCG criteria and medical policy/contractual benefits.

• Coordinate with patients and providers to produce high quality care

Qualifications of the Remote Utilization Management Nurse:

• RN or LPN- North Carolina license

• 3 + years of clinical experience, inpatient, ER/emergency clinical experience

• Case Management experience

• Utilization Management experience

Compensation for the Remote Utilization Management Nurse:

• Annual Salary Range: $76,000-$79,000
• Comprehensive Benefits: Medical, Dental, Vision, 401k

Skills: RN, LPN, registered nurse, ER, Inpatient, emergency room, case management, CM, Care Management, Case Manager, utilization management, UM, MCG, Medical Necessity

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