November 4, 2024

Walker Healthforce, LLC

CONTRACT

Registered Nurse | Utilization Management Appeals Nurse | Remote | Contract

Registered Nurse | Utilization Management Appeals Nurse | Remote | Contract

Walker Healthforce is seeking a Utilization Review Nurse for a healthcare client located remotely. This is a contract opportunity.

Eligible candidates must be local to one of the following states: NJ, NY, PA, DE or CT.

Start Date: ASAP

Walker Healthforce Standard Perks:

Weekly pay via Direct Deposit
Medical, Dental, and Vision Available
401K

JOB DESCRIPTION

Review and investigate Level 2 Commercial Appeals.
Assess and analyze UM denial reasons and appeal requests.
Make sound clinical judgments based on appeal reviews, adhering to regulations and clinical guidelines.
Present clinical findings and recommendations to committees.
Navigate multiple systems efficiently to maintain turnaround times.

JOB REQUIREMENTS

Must type 100 words per minute
Unrestricted Compact RN License
Proficient in UM policies and clinical guidelines

Proficient in Microsoft programs (Care Radius, Excel, One Note, Outlook, Teams, Word, etc.)

PREFERRED JOB REQUIREMENTS

Utilization Review Certification
Familiarity with UM Pharmacy appeals

Contact our Recruiting Team today to experience the Walker Healthforce difference!

ABOUT US
Walker Healthforce is known as the dominant force of performance, precision, expertise, and integrity in the healthcare consulting community! As a certified WMBE, we provide end-to-end healthcare IT and clinical solutions to hospitals, health systems, and payer organizations, including Fortune 100 firms nationwide. We are healthcare experts, we’re custom not commodity and we’ve been exceeding expectations for nearly 20 years. Join forces with us to experience unparalleled results today!

We are an Equal Opportunity Employer committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race, religion, color, age, sex, national origin, sexual orientation, gender identity, disability status or protected veteran status.

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