Iowa Licensed Utilization Management Nurse

Job Summary

Working onsite in Dubuque, IA, the full-time Iowa Licensed Utilization Management Nurse will evaluate and pre-certify requests for medical services while collaborating with healthcare providers and managing multiple calls in a fast-paced environment.

Key responsibilities

• Evaluate and pre-certify requests for hospital stays, outpatient surgeries, and other medical services
• Review requests against evidence-based guidelines to ensure medically necessary care
• Coordinate referrals to case management and condition management services based on health plan criteria

Required qualifications

• Active RN license in Iowa
• Clinical experience, preferably in ER, ICU, mental health, orthopedics, or pain management
• Strong multitasking skills in a fast-paced environment
• Bilingual candidates are preferred
• Experience with telephonic communication in a healthcare setting is a plus