Utilization Review Nurse(Austin/Richardson TX) (Remote) Job at Bracane Company, Inc., Richardson, TX

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  • Bracane Company, Inc.
  • Richardson, TX

Job Description

  • REMOTE - Candidates must be based in Texas: Austin area - Travis/Williamson Counties or Richardson area - Dallas/Collin Counties***

  • 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.

    JOB RESPONSIBILITIES:

    • This position is responsible for performing initial, concurrent review activities; discharge care coordination for determining efficiency, effectiveness, and quality of medical/surgical services, and serving as liaison between providers and medical and network management divisions.
    • Collects clinical and non-clinical data.
    • Verifies eligibility.
    • Determines benefit levels in accordance to contract guidelines.
    • Provides information regarding utilization management requirements and operational procedures to members, providers, and facilities.

    JOB QUALIFICATIONS (Required):

    • Registered Nurse (RN) with a valid, current, unrestricted license in the state of operations.
    • 3 years of clinical experience in a Physician's office, Hospital/Surgical setting, or Health Care Insurance Company.
    • Knowledge of medical terminology and procedures.
    • Verbal and written communication skills.

    JOB QUALIFICATIONS (Preferred):

    • MCG or InterQual experience
    • Utilization management experience

    LOCATION: REMOTE in Texas (Austin area – Travis/Williamson Counties or Richardson area – Dallas/Collin Counties).

    POSITION: 6-month assignment

    SALARY: $38 - $40 hourly

    HOURS PER WEEK: 40

    HOURS PER DAY: 8

Job Tags

Hourly pay, Contract work,

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