RN Utilization Management Consultant

Job Summary

A company is looking for a Utilization Management Nurse Consultant - Work From Home.

Key Responsibilities

• Utilizes clinical experience to assess, plan, implement, coordinate, monitor, and evaluate healthcare services for members
• Gathers clinical information and applies clinical criteria to render coverage determinations
• Communicates with providers to facilitate care and identifies referral opportunities

Required Qualifications

• Active, current, and unrestricted compact RN licensure in state of residence
• 3+ years of clinical experience required
• 1+ years of Microsoft Office Suite experience required
• Proficiency with computer skills, including navigating multiple systems
• Ability to work in a fast-paced environment