New York Licensed Utilization Nurse

Job Summary

A company is looking for a Utilization Management Nurse Consultant - Work From Home.

Key Responsibilities

• Assess, plan, implement, coordinate, monitor, and evaluate healthcare services/benefits for members
• Gather clinical information and apply clinical criteria to render coverage determinations
• Communicate with providers and identify members for referral opportunities to enhance care integration

Required Qualifications

• 2+ years of experience as a Registered Nurse in an adult acute care/critical care setting
• Active and unrestricted RN licensure in the state of residence
• Availability for a 24/7 operation, including weekends, holidays, and evening hours
• Associates Degree required; BSN preferred