Job Summary
A company is looking for a Utilization Management Nurse Consultant for a remote position.
Key Responsibilities
- Coordinate and document all aspects of the utilization/benefit management program
- Assess, plan, implement, and evaluate healthcare services and benefits for members
- Communicate with providers to facilitate care and identify 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
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