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Utilization Review Nurse
Scottsdale, Arizona

Our client is HIRING NOW for a Utilization Review Nurse in Scottsdale. This long term contract position is Full Time (on-location) Monday – Friday (8:00 am to 5:00 pm).

*****Hourly rate of pay is $55.00 an hour – Benefits Offered after 90 days****

General Job Duties:

Verify appropriate data is tracked to monitor the utilization management program process
Review medical necessity and appropriateness of medical services before authorizing and/or collaboration with physician
Respond to all requests appropriately, accurately, and timely according to Case Management and Primary Care guidelines
Educate patients on denials to help them better understand the limitations of their benefits
Prepare written clinical case summaries to include for recommended services

General Job Requirements:

Knowledge in areas such as Medicare and Medicaid Utilization Management regulations to include Medicare Administrative Contractor (MAC) for updated National Coverage Determinations (NCD) as well as Local Coverage Determinations (LCD)
Registered Nurse with active Arizona license
Minimum of 1 – 2 years’ experience including Primary Care Case Management – desired
Two years of clinical nursing experience in acute care or outpatient setting
Experience in utilization management preferred
CCM (Certified Case Manager Desired)

To apply for this position, please contact Angelique at (602.788.5890 Ext 115) or by email angelique@apnusa.com