California Licensed Utilization Management RN

Job Summary

A company is looking for a Utilization Management RN.

Key Responsibilities

• Direct oversight of day-to-day operations within the designated UM team
• Assist the team in reviewing prior-authorization requests for medical necessity and appropriateness
• Collaborate with providers and clinical staff to resolve utilization management issues

Required Qualifications

• Minimum of three (3) years of relevant clinical nursing experience
• Strong preference for prior PACE experience
• Two (2) years of supervisory experience with aptitude to mentor team members