Utilization Management Nurse
Company: VirtualVocations
Location: Knoxville
Posted on: September 17, 2023
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Job Description:
A company is looking for a Utilization Management Nurse.
Key Responsibilities:
Perform pre-service and post-service UM authorization reviews
utilizing federal and state mandates
Work with non-clinical team to obtain additional clinical
information, as needed
Approve requests that meet eligibility, benefit, and medical
necessity criteria
Required Qualifications:
Active, Licensed Vocational Nurse, or Licensed Practical Nurse
license
Minimum of 3 years of nursing in an acute or outpatient setting
Minimum of 2 years of UM experience in a managed care, payor
environment
Experience with Medicare and Medicaid (not required, but highly
desirable)
Experience with UM authorizations and appeals for DMEPOS (not
required, but highly desirable)
Keywords: VirtualVocations, Knoxville , Utilization Management Nurse, Healthcare , Knoxville, Tennessee
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