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Utilization Nurse Reviewer

Mountain Pacific
Full-time
Remote
United States
$27.88 - $34 USD hourly
Appeals Nurse

​​Mountain Pacific was established in Montana, in 1973. Mountain Pacific is a nonprofit organization that partners within our communities to provide solutions for better health. Through federal, state and commercial funding and partnerships, we bring national public health priorities to the local, state or regional level, leveraging our dynamic staff members’ wide range of expertise to advance better health and health care services.

We have an opening for a:
Utilization Nurse Reviewer (Remote)

This position is responsible for completing the day-to-day activities of the Deloitte Total Quality Management Contractor (TQMC) utilization review (UR) contract. This position performs quality assurance, standard of care, and clinical reviews to evaluate medical necessity for services under the contract. This position works closely with, the lead reviewer, peer reviewers, the UR supervisor, and our contractor to ensure services are delivered per contract requirements and our customers are delighted.

Why Work at Mountain Pacific?

  • Innovative Environment: Be part of a team that is at the forefront of health care innovation.
  • Professional Growth: We provide continuous learning and development opportunities to help you advance in your career.
  • Community Impact: Contribute to meaningful projects that improve health outcomes in our communities.
This position is a Full-time Remote position. The successful candidate would have excellent written and verbal communication, organizational skills, and attention to detail. A bachelor's degree in a related field with current licensure in the State of Montana with a minimum of 4 years' experience in acute care, nursing home, and/or utilization review, quality review preferred. Targeted compensation for this position is $27.88 to $34.00 an hour.  The first review of candidates will be on March 6, 2025, and continually reviewed every 5 days after.
 
At Mountain Pacific we offer a robust benefits package!
  • 401(k) with an automatic 3% employer contribution
  • Medical, Dental, Vision, Life, Flex Spending Account, Dependent Care Flex, and Health Saving Account
  • Paid Vacation, Sick, Holiday, Short-Term Disability and Long-Term Disability Leave
  • And much more!​​​​​​​​​​​

Mountain Pacific is an equal opportunity employer. We welcome applications from all qualified individuals, regardless of age, race, color, religion, sex, national origin, marital status, disability, veteran status, sexual orientation, sex identity, or any other characteristic protected by law. We are committed to providing a safe, productive, and professional work environment that promotes the dignity and well-being of every employee.

You may apply electronically or by emailing your resume to [email protected].   Learn more about the company by visiting our website at www.mpqhf.or