Illinois Licensed Utilization Nurse

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 to evaluate medical necessity and quality of care
• Manage care coordination and support eligible members with 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
• Strong proficiency in Microsoft 365 applications
• Meets Illinois CE requirement of 20 hours per 2-year RN license renewal cycle