Utilization Review Nurse

Key Responsibilities:

• Complete medical necessity reviews and level of care reviews for requested services.
• Obtain necessary information via phone and fax to assess member's condition and apply guidelines.
• Meet required decision-making SLAs and refer members for further care engagement.

Requirements:

• Active unrestricted RN licensure or compact multistate license.
• 1+ year of utilization review experience in managed care.
• Strong experience with MCG or InterQual. 1+ years clinical experience in acute care.
• Weekend availability required.

Culture & Benefits:

• Oscar fosters an inclusive environment where authenticity is valued.
• We offer medical, dental, vision, 401(k), paid parental leave, and more.
• We are an equal opportunity employer.