Job Summary
A company is looking for a Utilization Management Nurse Consultant - Remote.
Key Responsibilities
- Assess, plan, implement, coordinate, monitor, and evaluate healthcare services for members
- Gather clinical information to render coverage determinations based on clinical criteria and guidelines
- Communicate with providers to facilitate care and identify referral opportunities for members
Required Qualifications
- 2+ years of experience as a Registered Nurse
- Active current and unrestricted RN licensure in the state of residence
- Associate's Degree required
- BSN preferred
- 2+ years of clinical experience in med surg or specialty area preferred
Comments