Remote Psychiatric Nurse Practitioner
- Category: Nurse / Compounder Jobs
- Location: New Boston, Illinois
- Job Type: Full Time / Part Time
- Salary: Estimated: $ 18K to 22K
- Published on: 2025/09/25
One of the largest health insurers in the nation is focused on continuously building an industry-defining, world-class IT capability. Healthcare is forever evolving, especially due to emerging technologies, making this a great experience to add to your resume. Come join their winning team!
This contract role as a Remote Utilization Review Nurse in Richardson, TX must be a Registered Nurse working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan.
Pay rate: 38.45 – 41.45 per hour
Responsibilities:
• Responsible for performing accurate and timely medical review of claims suspended for medical necessity, contract interpretation and pricing.
• Initiate and/or respond to correspondence from providers or members concerning medical determinations.
Job Requirements:
• Knowledge of accreditation, i.e. URAC, NCQA standards and health insurance legislation.
• Awareness of claims processes and claims processing systems.
• PC proficiency to include Microsoft Word and Excel and health insurance databases.
• Verbal and written communication skills with ability to communicate to physicians, members and providers and compose and explain document findings.
• Organizational skills and prioritization skills.
• Registered Nurse (RN) with unrestricted license in state.
• 3 years clinical experience.
Related jobs
-
Nurse Practitioner Opportunity
*Registered Nurse / RN Opportunity at The Pediatric Connection** We are seeking an experienced Registered Nurse to join our team at The Pediatric Connection. As a Registered Nurse, you will play a vital role in providing high-quality clinical home ca...
-
LPN/Travel Nursing IMMEDIATE HIRE
Uniti Med is seeking a LPN / LVN Long Term Care for a travel job in New Boston, Texas. Job Description & Requirements Specialty: Long Term Care Discipline: LPN / LVN Start Date: ASAP Duration: 12 weeks Shift: days Employment Type: Travel Uniti Me...
-
Vocational Nurse (LVN) - Telford Unit
The mission of Correctional Managed Care is to address the healthcare needs of underserved patient populations within the Texas Department of Criminal Justice (TDCJ) and the Texas Juvenile Justice Department (TJJD). JOB SUMMARY: To provide direct nur...