Utilization Review Nurse (RN)

A Utilization Review Nurse (RN) job opportunity is now available through Adecco Medical & Science.

The is a TELECOMMUTE position with shifts Monday – Friday, 9-5 CT and 10- 6 CST or 11- 7 CST.

Responsibilities:

Assesses and interprets customer needs and requirements.
Review clinical information and make medical necessity recommendations.
Solves moderately complex problems and/or conducts moderately complex analyses.
Provides explanations and information to others on difficult issues.
Provide Care Advocacy and support for families navigating the complexities involved with Autism Diagnosis.
Facilitate member and caregiver education.
Ensure caregivers understand treatment options and are effectively linked to treatment resources.
Review benefits with the purpose of determining members eligibility for enhanced autism services.
Exhibit excellent customer service in engaging providers in collaborative planning.
Quote and explain benefit coverage to members and to providers. Follow appropriate benefit eligibility procedures.
Create and maintain excellent clinical records.


Qualifications:


Master’s Degree. REQUIRED
A valid clinical license (i.e., CSW, MFCC) OR be a Board-Certified Behavior Analyst. REQUIRED
Minimum of 3 years’ experience working with children and families. Preference for experience with Autism Disorders.
Independently Licensed Mental Health Clinician or Board-Certified Behavior Analyst.
Strong operational focus with demonstrated project management, change management, and execution skills.
Self-motivated and able to work with little direct supervision and drive results with disciplined follow-though.

If you are interested in this Utilization Review Nurse (RN) job, then please click APPLY NOW. For other opportunities available at Adecco Medical and Science go to www.adeccousa.com.

Equal Opportunity Employer Minorities/Women/Veterans/Disabled


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Reference number US_EN_2_106405_333655