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Registered Nurse at ICONMA

Remote:

Full Remote

Contract:

Fixed term

Experience:

Mid-level (2-5 years)

Work from:

United States

Offer summary

Qualifications:

Associate Degree or nursing diploma required, Two years patient care experience, Experience in ICU/ER preferred, InterQual knowledge preferred, Must have unrestricted RN license.

Key responsabilities:

Review precertification admission and concurrent reviews
Utilize InterQual criteria for inpatient appropriateness
Collaborate with facilities and providers
Reference data via PC
Conduct utilization review

ICONMA Human Resources, Staffing & Recruiting Large https://www.iconma.com/

1001 - 5000 Employees

See more ICONMA offers

Job description

Location: Remote
Duration: 10 months

Description:
Responsible for the review of precertification admission and concurrent reviews for the appropriateness of the inpatient setting utilizing InterQual criteria. Required to enter or reference data via PC, collaborate with facilities, providers and Medical Directors. Must have excellent written and oral communication skills. Other related skills may be required to perform this job. Two (2) to four (4) years of clinical experience which may include acute patient care, discharge planning, case management, and utilization review, etc. Demonstrated clinical knowledge and experience relative to patient care and health care delivery processes. One (1) year health insurance plan experience or managed care environment preferred.

Requirements:
Associate Degree or nursing diploma required.
At least two (2) years patient care experience.
Triage, case management, emergency room or ICU experience or utilization review experience with an insurance company preferred.
Expertise in the use of medical terminology.
InterQual knowledge preferred

Top 3 Required Skills/Experience –
2 years acute care experience with an unrestricted Registered Nurse license
ICU/ER preferred should not just be 2 years in a specialized field such as NICU/OB/BH/Substance Abuse
InterQual/MCG or other utilization review experience

Required Skills/Experience – The rest of the required skills/experience. Include:
Advanced computer skills
40+ WPM typing
Good verbal and written communication skills

Preferred Skills/Experience – Optional but preferred skills/experience. Include:
Utilization Review experience at a previous insurance company (medical, surgical admissions)
Utilization Review experience in an acute care setting

Education/Certifications – Include:
Must be a RN with an unrestricted Registered Nurse license

As an equal opportunity employer, ICONMA provides an employment environment that supports and encourages the abilities of all persons without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.