Registered Nurse Utilization Consultant

Job Summary

A company is looking for a Utilization Management Nurse Consultant (Remote).

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
• Communicate with providers to facilitate care and identify opportunities for quality improvement in healthcare services

Required Qualifications

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