Illinois Licensed Utilization Nurse

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 clinical determinations
• Collaborate with medical professionals for evaluations of medical necessity and care quality
• Manage care coordination and member support, including referrals to disease management programs

Required Qualifications

• Active, unrestricted Registered Nurse (RN) license in Illinois
• 5+ years of experience in varied healthcare settings
• Knowledge of utilization review and managed care processes
• Strong proficiency in Microsoft 365 applications
• Meets Illinois continuing education requirements for RN license renewal