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Florida Licensed Utilization Management Nurse

7/11/2025

N/A

Job Summary

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

Key Responsibilities
  • Assess requests for medical services for medical necessity and adherence to clinical guidelines
  • Collaborate with healthcare providers to make informed utilization management decisions
  • Monitor and track medical service utilization to identify trends and improve cost-efficiency and quality of care
Required Qualifications
  • Registered Nurse (RN) license in good standing within state of practice
  • Bachelor's degree in Nursing or a related field preferred
  • 2 years of experience in Utilization Management
  • Previous training in negotiations, Quality Assurance, and Case Management outcomes
  • Strong knowledge of evidence-based clinical guidelines and medical terminology

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