K.A. Recruiting


Registered Nurse - Utilization Review

Portsmouth, NH 03803

Job Type: Nursing Opportunities - Staff Level Job Number: KAM26025

Full-time Utilization Review Nurse/RN Case Manager needed at a school providing ground-breaking services to children and adults with disabilities!
(Reference Code: KAM)

Position Title: Utilization Review Nurse/RN Case Manager
Reports to: Director Clinical Services

SCOPE: Responsible for determining medical necessity, appropriateness of care, level of care, and quality of care medical reviews for patients in accordance with all state mandated regulations and insurance company contracts program.

QUALIFICATIONS:
* Current RN license issued by the State of New Hampshire Board of Nursing
* Strong knowledge of clinical UR and QA, Medicaid, Medicare guidelines and covered services
* Strong knowledge of InterQual/Milliman,MCG, ICD 10 Codes, and MCG Criteria
* Strong in Microsoft Office
* Working knowledge of behavioral health, substance abuse and human service resources.
* Case Management certification desired

SCHEDULE:  Monday–Friday 8:00-4:00
On-Call rotation for after hour’s coverage
Flexibility as program needs dictate

Offering competitive compensation and benefits!
For more information, please submit your resume for review.

Please click APPLY ONLINE or email us a copy of your resume directly (my email is next to my profile). Be sure to check out all of our jobs at http://jobs.ka-recruiting.com. We look forward to working with you!

Katherine Marano
Healthcare Recruiter

Katherine recruits and places healthcare professionals into full time permanent positions across the country. She works closely with laboratory professionals, and would love to address your hiring needs and help fulfill your career goals!

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