Commercial Utilization Review Nurse/RN- Remote in VA
Sentara(1 month ago)
About this role
A Utilization Review Nurse at Sentara Health is an RN clinician who provides utilization management services for health plan members, working remotely from Virginia. The role supports clinical and administrative teams to promote appropriate care settings, regulatory compliance, and quality outcomes within the health plan.
Required Skills
- Prior Authorization
- Inpatient Review
- Concurrent Review
- Retrospective Review
- Care Coordination
- Discharge Planning
- Appeals Management
- Clinical Assessment
- Provider Communication
- InterQual
+2 more
Qualifications
- BSN Preferred
- Registered Nurse (RN) License - Compact/Multi-State
About Sentara
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