Utilization Review Nurse in Albuquerque, NM at Volt

Job Description

Volt Workforce Solutions is seeking a great candidate for a work from home position, must reside in Albuquerque, NM.  

In this position you will be responsible for  performing initial and annual NFLOC (Nursing Facility Level of Care) reviews including LTSS services. UM Nurse serves as liaison between providers and Care Coordination Division. This position conducts NFLOC reviews, service requests reviews, verifies eligibility, determines benefit levels in accordance to contract guidelines, identifies and reports cases, and provides information regarding utilization management requirements and operational procedures to Care Coordinators, providers and facilities.

Requirements are:

• Must have high speed internet, Smartphone and a comfortable place to work. 
• Must be an RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan.
• Must have valid current unrestricted license in the state of NM

Don't wait!  Apply Today!

Volt is an Equal Opportunity Employer.