Utilization Management Nurse

Company: Aerotek
Location: Des Moines
Posted on: April 10, 2021

Job Description:

Position:

• Utilization Management NurseShift:
  • Monday-Friday 8am-5pmPay:
    • $28-29/hrQualifications:
      • Associate's or Bachelor's degree in Nursing
      • Must have an active State RN License
      • Working knowledge of Utilization Management processJob Description:
        • Responsible to collaborate with healthcare providers and members to promote quality member outcomes, to optimize member benefits, and to promote effective use of resources
        • Ensures medically appropriate, high quality, cost effective care through
        • Works with medical directors in interpreting appropriateness of care and accurate claims payment
        • May also manage appeals for services denied
        • Conducts pre-certification, continued stay review, care coordination, or discharge planning for appropriateness of treatment setting reviews to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits, and contracts
        • Ensures member access to medical necessary, quality healthcare in a cost effective setting
        • Consult with clinical reviewers and/or medical directors to ensure medically appropriate, high quality, cost effective care throughout the medical management process
        • Facilitates member care transition About Aerotek:We know that a company's success starts with its employees. We also know that an individual's success starts with the right career opportunity. As a Best of Staffing Client and Talent leader, Aerotek's people-focused approach yields competitive advantage for our clients and rewarding careers for our contract employees. Since 1983, Aerotek has grown to become a leader in recruiting and staffing services. With more than 250 non-franchised offices, Aerotek's 8,000 internal employees serve more than 300,000 contract employees and 18,000 clients every year. Aerotek is an Allegis Group company, the global leader in talent solutions. Learn more at Aerotek.com.The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

Keywords: Aerotek, Des Moines , Utilization Management Nurse, Executive , Des Moines, Iowa