Oklahoma Licensed Utilization Review Nurse

A company is looking for a Case Manager - Utilization Review Nurse (WFH).

Key Responsibilities

Conduct timely medical necessity reviews for patients using established criteria

Communicate with insurance companies and present cases to the Medical Director as needed

Review and audit patient treatment records to ensure compliance and prevent unnecessary procedures

Required Qualifications

Graduate from an accredited school of nursing; Bachelor of Science in Nursing preferred

Three years of clinical nursing experience in an acute care facility

Current RN License issued by the Oklahoma State Board of Nursing or a multistate Compact RN License

Experience with utilization review or case management preferred

Case management certification preferred