Registered Nurse - Outpatient Utilization Review Nurse - SUNYWNYRN Job at NavitsPartners, Kenmore, WA

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  • NavitsPartners
  • Kenmore, WA

Job Description

Registered Nurse – Outpatient Utilization Review Nurse

Qualifications:

  • RN license with experience in outpatient case management or utilization review.
  • Minimum of 2 years of experience in ambulatory or outpatient settings.
  • Strong understanding of medical necessity criteria for outpatient services.
  • Familiarity with managed care policies and insurance guidelines.
  • Excellent organizational and analytical skills.

Duties:

  • Evaluate the appropriateness of outpatient procedures and treatments.
  • Work with healthcare providers to streamline pre-authorization processes.
  • Monitor resource utilization and recommend cost-effective care strategies.
  • Analyze outpatient case data and ensure compliance with payer regulations.
  • Assist in coordinating referrals and follow-up care.
  • Educate providers on best practices for utilization management.

Pay:

  • Medium weekly pay range: $2,000 - $2,500

Job Tags

Weekly pay,

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