Utilization Management Nurse Consultant

Job Summary

A company is looking for a Utilization Management Nurse Consultant - Fully Remote.

Key Responsibilities

• Coordinate, document, and communicate aspects of the utilization/benefit management program
• Gather clinical information and apply criteria to render coverage determinations
• Consult with providers and other parties to facilitate care and identify referral opportunities

Required Qualifications, Training, and Education

• Active nursing license
• Experience in utilization management or clinical care coordination
• Knowledge of clinical criteria and guidelines
• Ability to work in a remote setting with required internet specifications
• Availability for occasional weekend/holiday coverage