Arkansas Licensed Utilization Management Nurse

Job Summary

A company is looking for a Utilization Management Nurse (RN).

Key Responsibilities

• Perform clinical review of prior authorizations and medical services to ensure appropriate care levels
• Assess medical necessity using evidence-based criteria and collaborate with healthcare providers to promote quality care
• Conduct comprehensive case reviews and ensure compliance with regulatory standards and nursing scope of practice

Required Qualifications

• Active, unrestricted Registered Nurse (RN) license in good standing
• Minimum 4 years of clinical nursing experience in relevant settings (e.g., Medical-Surgical, ICU)
• Strong critical thinking and clinical judgment skills
• Proficient in Microsoft Office and comfortable navigating multiple systems
• Ability to work independently while fostering collaborative relationships across teams