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Utilization Review Nurse

Innovative Systems Group
Chicago, IL
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This is full-time remote, but candidates must reside in IL or TX Contract: ...
Details
Summary
About the job:
2025-08-11 to 2025-12-31 RN working in the insurance or managed care industry using medically accepted criteria to validate the medical necessity and appropriateness of the treatment plan . This position is responsible for performing accurate and timely medical review of claims suspended for medical necessity, contract interpretation, pricing; and to initiate and/or respond to correspondence from providers or members concerning medical determinations. Qualifications: - Knowledge of accreditation , i.e. URAC , NCQA...
Location:
Chicago, IL
Job Type:
Full-Time
Permanent
Occupation:
Registered Nurses
Career Level / Education:
Bachelor's degree
Salary:
Six Figure Jobs (more than $100K)
From:
Qureos
Certifications / Licenses:
Certified Registered Nurse
National Committee for Quality Assurance
Workkeys
Applied Math
N/A
Graphic Literacy
N/A
Workplace Documents
N/A
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