MN Licensed Utilization Management RN

Job Summary

A company is looking for a Utilization Management Specialist.

Key Responsibilities

• Conduct medical necessity reviews and perform utilization management activities to ensure compliance with accreditation and regulatory requirements
• Collaborate with healthcare team members to promote appropriate resource utilization and assist in documentation improvement practices
• Monitor resource utilization and quality of care, ensuring compliance with professional standards and regulatory requirements

Required Qualifications

• Bachelor's degree in nursing preferred; graduate from a nationally accredited nursing program required
• Currently holds an unencumbered registered nurse (RN) license with the State Board of Nursing
• Maintains required department-specific competencies and certifications