RN Utilization Management Consultant

Job Summary

A company is looking for a Utilization Management Nurse Consultant specializing in Medical Review.

Key Responsibilities

• Implement, coordinate, monitor, and evaluate medical review cases using clinical expertise
• Render medical determinations based on clinical criteria and guidelines
• Assist in training new nurse reviewers and recommend process improvements

Required Qualifications

• Active, unrestricted RN license with multistate/compact licensure privileges
• Minimum of 3 years of clinical experience
• 5 years of experience making independent clinical decisions
• 1+ year of experience in Utilization Review Management and/or Medical Management
• Commitment to complete a mandatory 3-week training program