Kansas Licensed Utilization Nurse Consultant

Job Summary

To support a 24/7 Utilization Management operation, the full-time Kansas Licensed Utilization Nurse Consultant will assess, plan, implement, and evaluate healthcare services for members while working remotely and managing communication with providers and other parties.

Key responsibilities

• Utilizes clinical expertise to assess and facilitate appropriate healthcare services and benefits for members
• Gathers clinical information and applies criteria to render coverage determinations along the continuum of care
• Identifies opportunities for quality improvement in healthcare services and collaborates with internal and external stakeholders

Required qualifications

• 2+ years of experience as a Registered Nurse in an adult acute care or critical care setting
• Active, current, and unrestricted RN licensure in the state of residence
• Associates Degree in nursing required; BSN preferred
• Availability to work weekends, holidays, and evening hours as part of a 24/7 operation