See all roles

Utilization Review Nurse (2+ Yrs. InterQual Exp Required) Full-time Weekends

Work from home Full-time role Hiring

Job Description--Full-Time Weekends 7:30am-6pm Wed-Sat Are you an experienced utilization review nurse ready to showcase your clinical knowledge with a cohesive team of medical, administrative and IT experts? EdiPhy Advisors LLC, a nationwide provider of highly customized physician advisor services, is expanding our licensed Clinical Care Coordinator team. EdiPhy Advisors is a URAC-accredited provider, demonstrating excellence in compliance for more than 20 years. Our Birmingham, Alabama offices are located in Liberty Park’s award-winning Urban Center, conveniently located off I-459. Requirements:

  • 2 years of InterQual experience
  • Active RN license
  • 3-5 years clinical experience as an RN in a critical care environment is required. Med/surg preferred;
  • Strong clinical skills and knowledge, and the ability to recognize when quality issues exist;
  • Outstanding computer, interpersonal, and organizational skills;
  • Proficiency in written and verbal communication;
  • Great problem-solving expertise and enthusiasm for analyzing complex situations;

Essential Duties and Responsibilities Include: Our nurses work with a strong group of board certified practicing physicians, skilled administrators and a state-of-the-art technical staff to review medical records and advise on things like level of care, medical necessity, services needed, outcomes evaluations and clinical audits. They communicate every day in a complex, time-sensitive manner to assure that quality, cost-effective health care is provided in the most appropriate setting. Job Type: Full-time Expected hours: 40 per week Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Disability insurance
  • Flexible spending account
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

Application Question(s):

  • Have you passed at least one InterQual IRR exam created by Change Health?

Experience:

  • InterQual: 2 years (Required)

License/Certification:

  • RN License (Required)

Work Location: Remote Apply tot his job Apply To this Job

You might like

Pre-Authorization Specialist I

Work from home Full-time role

Remote Prior Authorization Pharmacy Technician {169974}

Work from home Full-time role

Clinical Review Nurse – Prior Authorization

Work from home Full-time role

Prior Authorization / SME

Work from home Full-time role

Remote Medical Review Nurse (RN) – Must Work CST time zone

Work from home Full-time role

Prior Authorization Coordinator

Work from home Full-time role

Telephonic Utilization Management & Complex Case Manager, Registered Nurse (Full Time, Remote)

Work from home Full-time role

Clinical Review Nurse – Concurrent Review, Multiple Locations

Work from home Full-time role

Utilization Management Nurse Consultant

Work from home Full-time role

Prescription Prior Authorization Specialist

Work from home Full-time role

Remote Bilingual Italian Generalist Evaluator Expert

Work from home Full-time role

Senior Specialist, GTM Readiness

Work from home Full-time role

Developer Engagement Representative - Indonesia (Part-Time Contract)

Work from home Full-time role

Experienced Customer Service Representative – Work from Home Opportunities with arenaflex

Work from home Full-time role

Entry Level Java Developer - Remote

Work from home Full-time role

Central Intake Coordinator-Home Health

Work from home Full-time role

Experienced Data Entry Specialist – Remote Opportunity at arenaflex

Work from home Full-time role

Experienced Customer Support Representative – Amazon Chat Support Team – Work From Home Opportunity

Work from home Full-time role

Client Strategy & Operations Manager

Work from home Full-time role

Outside Sales Professional

Work from home Full-time role