Description

American Traveler is hiring a travel RN for a fully remote Utilization Review position requiring a minimum of 5 years of RN experience and current UR experience with Epic and InterQual.

Details

• Fully remote position — no on-site or facility-based work required
• Monday through Friday, 8:00 AM – 5:00 PM EST schedule
• No call, holiday, or weekend requirements
• Managed care / health plan setting focused on utilization management; no direct patient care
• Monitors appropriateness of care for plan members across acute hospital, sub-acute, and acute rehabilitation settings
• Utilizes Epic EMR and InterQual criteria software
• 8-week contract

Requirements

• Active MD or Compact RN license currently in hand
• Current BLS certification required
• Minimum 5 years of RN experience required
• Current utilization review (UR) experience required
• Proficiency with InterQual criteria software required
• Epic EMR experience required
• Managed care experience in utilization review of at least 1 year preferred
• Must provide own computer equipment — no equipment will be issued
• SSN and DOB required for consideration
• 1 professional reference required for consideration

Additional Information

• Responsible for day-to-day utilization management of health plan members in acute care and/or rehabilitative facilities
• Applies member benefit and medical criteria to determine authorization of services in coordination with Medical Directors
• Proactively initiates discharge planning, including identification of post-discharge needs and coordination of referrals and services
• Communicates authorization and/or denial of covered services verbally and in writing with providers, facilities, and members
• Strong verbal and written communication, interpersonal, and conflict resolution skills are essential for this role
• Local candidates are accepted at the same bill rate