RN (Registered Nurse)

Immediate need for a talented RN (Registered Nurse). This is a Fulltime opportunity with long-term potential and is located in Missouri(Remote). Please review the job description below and contact me ASAP if you are interested.
 
Job ID: 25-68406
 
Pay Range: $67000 - $68000/annum.  Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).
 
Key Responsibilities: 

• Review patient medical documentation and make on-line payment determinations for claims and prior authorizations that require medical determination.
• Review exception requests under the direction of MO HealthNet Division (MHD) staff
• Review decisions are based on MHD policy and professional nursing judgment and experience.
• Uses MMIS and exceptions database to process review outcomes.
• Responsible for working with healthcare professionals to review requests for non-covered services.
• Responsible for reviewing requests for medical services and supplies.

 
Key Requirements and Technology Experience:  

• Key skills; Registered Nurse/RN
• Utilization Review, Claims Review and Clinical Review
• Clinical, Outpatient, Provider or Nursing Experience
• Registered Nurse with an Active Missouri Nursing License
• Bachelor’s degree in nursing with a least one year of professional nursing experience or.
• Graduate of school of nursing with at least two years of professional nursing experience
• Varied nursing background and experience (hospital, physician’s office, outpatient facility, UR etc.)
• Computer Skills and Utilization Review experience, desired.
• Candidate must have excellent written and verbal communication skills.

 

Our client is a leading IT Industry, and we are currently interviewing to fill this and other similar fulltime positions. If you are interested in this position, please apply online for immediate consideration.

Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy 

. #prof J2W:CB3