Illinois Licensed Utilization Management RN

Job Summary

A company is looking for a Utilization Management Registered Nurse.

Key Responsibilities

• Conduct timely reviews of healthcare services and document clinical findings in compliance with regulations
• Collaborate with medical professionals for evaluations of medical necessity and treatment appropriateness
• Coordinate care and support for members, including referrals to disease management programs

Required Qualifications

• Active, unrestricted Registered Nurse (RN) license in Illinois
• 5+ years of experience in various healthcare settings
• Knowledge of utilization review and managed care processes
• Completion of 20 hours of continuing education every 2 years for RN license renewal
• Strong proficiency in Microsoft 365 applications