Licensed Utilization Management Nurse

Job Summary

A company is looking for a Utilization Management Nurse Consultant for a remote position.

Key Responsibilities

• Utilize clinical skills to coordinate, document, and communicate aspects of the utilization/benefit management program
• Assess, plan, implement, coordinate, monitor, and evaluate healthcare services/benefits for members
• Communicate with providers to facilitate care and identify members for referral opportunities

Required Qualifications, Training, and Education

• 1 year of experience in Utilization Management, concurrent review, or prior authorization
• 5 years of clinical experience required
• 5 years of demonstrated ability to make independent clinical decisions
• Registered Nurse with an unrestricted license in the state of residence
• Associate's nursing degree (RN) minimum required; Bachelor's degree preferred