Job Title: Utilization Management RN
Location: Remote – must reside within the PA/NJ/DE tri-state area for potential conversion to full-time
License Requirement: Active Pennsylvania RN license or Nurse Licensure Compact (including PA) required
Overview
The Utilization Management RN plays a vital role in evaluating members’ clinical conditions through detailed medical record review to determine medical necessity for services. Using advanced clinical knowledge and independent analysis, this position applies appropriate medical criteria to support high-quality, cost-effective care decisions.
This is a remote position with the opportunity for future on-site conversion.
Key Responsibilities
Education/Licensure & Experience
...Our client, a design company, is looking for a motivated Graphic Design Intern to join their creative team in Austin, Texas. This internship offers the opportunity to work on real-world projects, gain hands-on experience, and develop a strong portfolio. The ideal candidate...
...tilt bucket when filled and dumps material into truck or rail. Performs routine maintenance on loader such as lubricating and cleaning. Perform all work following company policies and procedures. Perform all work in a safe and professional manner. Obtain all...
...skip tracing to locate the members or vehicles. The Collection Representative will ensure policies and procedures are followed, and complete... ...Related Work Experience: Minimum two years of credit union or banking experience. Skills: Account Collections; Collection...
...functional field teams Strong safety track record with a commitment to compliance and best practices Experience working with union labor and multiple trade groups Ability to identify, assess, and mitigate project risks Tech / Project Breakdown Commercial...
...close the transaction every time . Ability to influence others . Must possess high school diploma or GED Other Information:CGI is required by law in some jurisdictions to include a reasonable estimate of the compensation range for this role. The determination...