Nevada Licensed Utilization Management RN

Job Summary

A company is looking for a Utilization Management RN.

Key Responsibilities

• Apply utilization management processes to evaluate medical necessity for services and facilities
• Coordinate with interdisciplinary teams to ensure quality care and resource utilization
• Document determinations and manage clinical denials in accordance with regulations

Required Qualifications

• Bachelor of Science in Nursing Degree preferred
• Minimum two years of clinical experience in an inpatient or outpatient setting required
• Two to three years of managed care utilization management or case management experience recommended
• Current and unrestricted State of Nevada Registered Nurse license required
• Utilization Management Certification desirable