Utilization Review Nurse

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Centurion Health
Published
August 17, 2021
Location
Saint Louis, Missouri
Job Type

Description

Utilization Review Nurse

  • St. Louis, Missouri
  • Nursing
  • 23748

Job Description

Centurion is proud to be the provider of comprehensive healthcare services to the Missouri Department of Corrections.  

We are currently seeking a full-time Utilization Review Nurse to join our Missouri Regional Office Team as a remote employee.


Responsibilities

The Utilization (UM) Nurse performs the review of requests for prior authorization of medical services, including diagnostic, outpatient care and services using defined criteria. Duties will include admissions though on-site and telephonic review to ensure medical necessity and appropriate level of care, review and audit of patient medical records as indicated to determine medical necessity, and serving as a clinical resource and liaison for site and hospital referral staff.


Qualifications

 

  • [Insert state name—no abbreviations—i.e. Florida] RN license or ability to obtain license
  • Utilization management experience, InterQual experience preferred
  • Two (2) years of clinical nursing experience and one year of experience in performing prior authorization review
  • Experience using medical management software programs
  • Experience working with a correctional institution or agency preferred
  • Must be able to pass background investigation and obtain agency security clearance

 


Available Shift

Monday - Friday, Dayshift


Benefits

We offer excellent compensation and comprehensive benefits for our full-time team members including:

  • Health, dental, vision, disability and life insurance
  • 401(k) with company match
  • Generous paid time off
  • Paid holidays
  • Flexible Spending Account
  • Continuing Education benefits
  • Much more...


About Us

Centurion Health contracts with state and local governments nationwide to provide comprehensive healthcare services to correctional facilities, state hospitals, and other community settings. Our dedication to making a difference and our passionate team of the best and the brightest healthcare employees has made us one of the leaders of the correctional health industry. Whether you are driven by purpose and impact or on a journey of professional growth, our opportunities can offer both.

indmhm

#AF38

 


EEO

 

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MHM Services, Inc. d/b/a Centurion Group, Inc. (“Centurion”) is an Equal Opportunity Employer.

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