The Denial/Utilization Review RN works within the Care Management Department to respond to medical necessity denials from all payer sources and to manage appeal processes as directed by Care Management leadership. This may include being involved in some elements of inpatient review processes as well as retrospective review processes.
Education, Licensure, Experience, and Other Requirements:
- Graduate from an approved Bachelor of Science in Nursing program.
- Current license to practice as a Registered Nurse in North Carolina.
- 2 years of acute care RN experience & 1 year of Case Management, UR, or related experience.
- Certification in Case Management and/or Utilization Review is preferred.
- $26.27 - $38.88/hour