Utilization Management Nurse Analyst
Company: VirtualVocations
Location: Vista
Posted on: May 23, 2025
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Job Description:
A company is looking for a UM Nurse Analyst (Remote).
Key Responsibilities
Review payer Medical Policy Guidelines to identify medical
necessity criteria
Construct attestation questions using programming language that
reflect medical necessity criteria
Serve as a Subject Matter Expert and resource for engineering teams
and developers
Required Qualifications
Bachelor's degree in nursing
At least 3+ years of experience in an outpatient Utilization
Management program or equivalent clinical experience
Familiarity with prior authorization submission practices
General power user of technology and confident in navigating new
applications
Understanding of interpreting medical records to identify
documentation of conditions and findings
Keywords: VirtualVocations, Baldwin Park , Utilization Management Nurse Analyst, Executive , Vista, California
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