Nezda is actively hiring for Utilization Review Nurse – USRN.
Qualifications:
✅ Active and Non-Active USRN License
✅ With at least 1 Year Clinical or Hospital Experience
✅ USRN with RN License
Job Description:
👉 We are in partnership to multiple companies for this position, so you have an option and which company fits you best.
👉 Please take note that this is a direct employment with no bond.
👉 Reviews service requests to ensure compliance with applicable criteria, medical policy, and member eligibility, benefits and contracts.
👉 Responsible for conducting medical management review activities which require the review of clinical information against client specific criteria as noted above but excludes denial determinations.
👉 Consult with clinical reviewers and/or U.S. licensed medical directors to ensure medically appropriate, high-quality, cost-effective care throughout the medical management process.