Registered Nurse - Utilization Management w/BONUS - 5186

RN - Utilization Management needed at Mountain Home Air Force Base in Mountain Home, Idaho.

Duties: The duties include, but are not limited to the following;

• Follows medical privacy and confidentiality (i.e. Health Insurance Portability and Accountability Act [HIPAA]) guidelines, The Joint Commission (TJC), and Clinical Practice Guidelines (CPGs).
• Works with computer applications/software to include Microsoft Office 365 programs, MS Outlook (e-mail) and internet usage.
• Must have a working knowledge of Ambulatory Procedure Grouping (APGs), Diagnostic Related Grouping (DRGs), International Classification of Diseases- Current Version (ICD), and Current Procedural Terminology-Current Version (CPT) coding; and McKesson (InterQual) and/or Milliman Care Guidelines.
• Performs prospective, concurrent, and retrospective reviews to justify medical necessity for requested medical care and to aid in collection and...

Ready to Apply?

Submit your application today and join our talented team at Vantage Search Group.