Utilization Management Nurse Consultant (RN)

Job Summary

A company is looking for a Utilization Management Nurse Consultant.

Key Responsibilities

• Work in a clinical telephone queue to secure additional information for prior authorization review
• Utilize clinical skills to coordinate and communicate all aspects of the utilization/benefit management program
• Identify members for referral opportunities and promote quality effectiveness of healthcare services

Required Qualifications

• 1 year of varied utilization management experience within an outpatient setting
• 5 years of diverse clinical experience, including acute care or long-term care
• 5 years of demonstrated ability to make independent clinical decisions
• Must be a Registered Nurse with an unrestricted license in the state of residence
• Residential broadband service with adequate internet speeds is required