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 using medical criteria to support determinations
• Collaborate with medical professionals for evaluations of medical necessity and quality of care
• Coordinate care and support members by identifying eligible participants for disease management programs

Required Qualifications

• Active, unrestricted Registered Nurse (RN) license in Illinois
• 5+ years of experience in diverse healthcare settings
• Knowledge of utilization review and managed care processes
• Proficiency in Microsoft 365 applications
• Meets Illinois CE requirement of 20 hours per 2 year RN license renewal cycle