Utilization Review Nurse

**Utilization Review Nurse at Oscar Health (Remote)** **What you'll do** - Complete medical necessity and level of care reviews using clinical judgment - Obtain information to assess member's clinical condition via telephone and fax - Meet required decision-making SLAs and refer members for further care engagement - Ensure compliance with all applicable laws and regulations **What they're looking for** - Active, unrestricted RN licensure from the United States - Associate Degree in Nursing or equivalent - 1+ year of utilization review experience in managed care setting - Strong experience utilizing MCG (Milliman Care Guidelines) **Details** - Location: Remote (multiple states available) - Type: Remote - Salary: $35.00-$45.94 per hour