North Carolina Licensed Clinical Specialist RN

Job Summary

A company is looking for a UM Clinical Specialist RN - Physical Health.

Key Responsibilities

• Assess the medical necessity of inpatient admissions, outpatient services, and surgical procedures
• Ensure compliance with utilization management policies and monitor adherence to clinical guidelines
• Collaborate with other departments and stakeholders to address performance issues and improve consumer outcomes

Required Qualifications

• Graduation from a state accredited school of nursing or an Associate's Degree in Nursing with five years of experience, or a Bachelor's degree in Nursing with three years of experience
• Current, active, and unrestricted North Carolina clinical license as a Registered Nurse, or a compact license
• Preferred experience in Utilization Management
• Knowledge of physical health conditions and diagnostic treatment guidelines
• Proficiency in the use of computer and multiple software programs