Utilization Review RN

healthcaresupportstaffing1
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📍 PA📍 Philadelphia📍 Philadelphia, PA, United States📍 us

About this role

Company Description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

• Evaluate clinical information submitted by providers against plan review criteria and benefit guidelines

• Utilize clinical information to determine if criteria for medical necessity and benefit guidelines are met

• Document pertinent case information for approvals and denials- refer cases failing to meet Interqual to Medical Director

• Act as liaison to ensure services are provided in the least restrictive, most cost effective and clinically appropriate setting

• ID and resolve problems that could interfere with provider’s continuity and coordination of care of members- refer unresolved problems to the manager


Qualifications

• Clear and active RN license in state of PA

• Minimum AS in nursing

• 2 years’ experience in acute care hospital AND 

• 2 years’ experience in managed care, quality assurance or utilization review setting


Additional Information

Hours for this Position:

40 hours a week

M-F, daytime hours



Advantages of this Opportunity: 

• Competitive salary, negotiable based on relevant experience

• Benefits offered, Medical, Dental, and Vision

• Fun and positive work environment

• Right to Hire opportunity

• Can start as early as next week    


Interested in being considered? 

If you are interested in applying to this position, please contact Steph Zymowski at 407-636-7030 ext.220  and click the Green I’m Interested Button to email your resume. 

Frequently Asked Questions

Is the salary disclosed for the Utilization Review RN position at healthcaresupportstaffing1?
The salary for this Utilization Review RN role at healthcaresupportstaffing1 is not publicly listed. Click "Apply Now" to learn more about the compensation package on their official careers page.
Where is the Utilization Review RN position at healthcaresupportstaffing1 located?
This Utilization Review RN role at healthcaresupportstaffing1 is based in PA, Philadelphia, Philadelphia, PA, United States, us. The position is listed as on-site or hybrid. Check the full job description or apply directly to confirm the work arrangement.
How do I apply for the Utilization Review RN position at healthcaresupportstaffing1?
Click the "Apply Now" button on this page. You will be redirected to healthcaresupportstaffing1's official application portal hosted on smartrecruiters where you can submit your application directly.
When was the Utilization Review RN job at healthcaresupportstaffing1 posted?
This Utilization Review RN position at healthcaresupportstaffing1 was posted on Oct 8, 2015. Apply as soon as possible — early applications are often reviewed first.
Utilization Review RN
healthcaresupportstaffing1
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