Utilization Management US Registered Nurse Senior Analyst

Career Opportunity: Utilization Management US Registered Nurse Senior Analyst

What you'll do:

• Grievance & Appeals: Creates complete appeal records for external appeal reviews, using standardized Independent Review Entity (IRE) forms and including all required documentation.
• Creates a detailed case summary in narrative format for each appeal.
• Submits cases as directed for each applicable geographic region.
• Presents verbal and written case summaries to client's Grievance Team and client Medical Directors.
• Completes assignments within client-designated turnaround times.

What we're looking for:

• Bachelor of Science Nursing (BSN) degree or General Nursing & Midwifery (GNM) Diploma or Basic Bachelor of Science (BSC) in Nursing degree or Associate Nursing Degree or Nursing Diploma
• Holds current and unrestricted US Registered Nurse license
• 3 months clinical experience (480 hours of working expe...