Iowa Licensed Utilization Management Nurse

Job Summary

Thriving in a fast-paced environment, the full-time Iowa Licensed Utilization Management Nurse will work onsite in Dubuque or remotely to evaluate and pre-certify provider requests for hospital stays, outpatient surgeries, and tests, ensuring medically necessary care according to evidence-based guidelines.

Key responsibilities

• Evaluate and pre-certify requests from providers telephonically, ensuring compliance with evidence-based guidelines
• Handle multiple provider phone calls simultaneously in a fast-paced environment
• Coordinate referrals to case management and condition management services as per health plan guidelines

Required qualifications

• Current RN license in Iowa
• Clinical experience in ER, ICU, mental health, orthopedics, and/or pain management
• Strong multitasking skills
• Bilingual candidates preferred