Day to Day:

Insight Global is looking for a Pre-Access Utilization Management Registered Nurse to sit remotely with one of their large health insurance clients. This person will be responsible for evaluating and collaborating with doctors, and other healthcare professionals. Day to day this individual will be assessing patient care requests for medical services (such as surgeries, procedures, hospital admissions, etc.) and collaborating with providers to ensure the requested services align with medical necessity. It is critical that this person adheres to company policies regarding confidentiality and privacy. This person needs to pay very close attention to detail, be a team player, have flexibility in their day to day, etc. Being an expert within the plan and benefit template is crucial, and having great written and verbal communication is important!

Must-Haves:

• Valid RN License in their state of Residence
• Alabama, Arizona, California, Colorado, Connecticut, DC, Florida, Georgia, Illinois, Iowa, Kansas, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Missouri, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, Tennessee, Texas, Utah, Vermont, Virginia, Washington
• 4-5 years of Remote Utilization Management experience at (Health Insurance)
• Experience using Milliman Care Guidelines (MCG)
• Proficiency in Google Suite Applications (google sheets, calendar, etc.)
• Experience utilizing a Macbook and working in a remote environment (including setting up work station, being on VPN, etc.)
• Ability to critically think and troubleshoot issues on their own.

Shift: Thursday-Sunday (4x10s) starting as early as 7am in respective time zone – flexibility to 5x8’s as well as long as they are working at least 1 weekend day

Compensation:

$37/hr to $43/hr

Exact compensation may vary based on several factors, including skills, experience, and education.

Benefit packages for this role will start on the 31st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.