Job Details
Centurion is proud to be a leading provider of comprehensive healthcare services to correctional facilities, state hospitals, and community mental health centers nationwide.
We are currently seeking a full-time Utilization Review Nurse to join our St. Louis Corporate Team.
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 through 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, assistance in completion of Medicaid applications for patients currently hospitalized and serving as a clinical resource and liaison for site and hospital referral staff.
Qualifications
- MO or compact RN 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
Qualified candidates may have the opportunity to work remote.
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…