Job Summary
A company is looking for a Utilization Management Nurse Consultant.
Key Responsibilities
- Assess, plan, implement, coordinate, monitor, and evaluate healthcare services for members
- Gather clinical information and apply clinical criteria to make coverage determinations
- Communicate with providers to facilitate care and identify referral opportunities
Required Qualifications
- Registered Nurse with active and unrestricted RN licensure in state of residence
- May need to obtain additional Nursing Licenses as required
- 1+ years of Managed Care Experience preferred
- 1+ years of clinical experience in acute or post-acute settings preferred
- Diploma RN acceptable; Associate degree/BSN preferred
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