Imaging Utilization Nurse Reviewer
Jobtailor
Jobtailor is seeking a licensed registered nurse to perform preauthorization reviews for diagnostic imaging, focusing on medical necessity and treatment appropriateness. You will collaborate with providers and members to optimize benefits and ensure high-quality outcomes. The role requires nursing experience, familiarity with UM guidelines, ICD-10/CPT-4 coding, and experience in utilization or quality management or call centers. On-site work is preferred in various settings. #J-18808-Ljbffr Jobtailor
Vacancy posted 2 days ago
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