Registered Nurse Utilization Consultant

Job Summary

A company is looking for a Utilization Management Nurse Consultant.

Key Responsibilities

• Coordinate, document, and communicate all aspects of the utilization/benefit management program
• Assess, plan, implement, coordinate, monitor, and evaluate healthcare services/benefits for members
• Gather clinical information and apply appropriate clinical criteria to render determinations along the continuum of care

Required Qualifications

• Active unrestricted state Registered Nurse licensure in state of residence
• Minimum 5 years of relevant experience in Nursing
• At least 1 year of Utilization Management experience in concurrent review or prior authorization
• Proficient with phone systems and clinical documentation tools
• Commitment to attend a mandatory 3-week training with 100% participation