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Registered Nurse - Review Analys
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Full-time
- Perform prospective, concurrent and retrospective review of inpatient, outpatient, ambulatory and ancillary services to ensure medical necessity, appropriate length of stay, intensity of service and level of care, including appeal requests initiated by providers, facilities and members.
- May establish care plans and coordinate care through the health care continuum including member outreach assessments.
- Above average computer skills (Microsoft office).
- Clinical experience in ICU, ER, or medical surgical unit preferred.
- Prefer utilization management experience.
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