Details for Mountain Pacific Quality Health - Ad from 2019-10-20

Nurse Reviewer Tired of evenings, weekends & holidays? Are you selfmotivated with exceptional organization skills? Under the Montana Medicaid Utilization Review (UR) contract, this position performs clinical review to evaluate the medical necessity for requested items under the Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) program. Due to the types of reviews received, many times extensive research is required to determine best practices and appropriateness of care. Some cases require working with the Medical Director to determine medical necessity. Position requires Registered Nurse with current Montana licensure; work experience in acute care, nursing home and/ or utilization review, quality review or related experience; experience with completing research to determine medical necessity or appropriateness of requested services; and good analytical and communication skills. Prior utilization review experience preferred. Apply oNliNe At: or e-mail Mountain-Pacific Quality Health 3404 Cooney Dr., Helena, MT 59602 EEOE

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