Remote Utilization Review Nurse Job at TriWest Healthcare Alliance, United States

  • TriWest Healthcare Alliance
  • United States

Job Description

TriWest Healthcare Alliance seeks a Utilization Management Clinical Review nurse to evaluate and authorize beneficiary care, focusing on cost-effective, appropriate utilization of Behavioral Health and Medical/Surgical services.

Responsibilities include preauthorization, inpatient and continued stay reviews, and presenting complex cases for Medical Director review, while staying compliant with InterQual and TriWest policies.

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