Registered Nurse Consultant

Job Summary

A company is looking for a Utilization Management Nurse Consultant specializing in Specialty Medications (Remote).

Key Responsibilities

• Participate in on-call rotations, including weekends and holidays, as required
• Conduct clinical reviews and collaborate with healthcare providers to gather necessary information
• Authorize services based on established guidelines or escalate cases to Medical Directors as needed

Required Qualifications

• Active unrestricted state Registered Nurse licensure in state of residence
• 1+ year of prior authorization experience with injectable/infused specialty medications
• Minimum 5 years of relevant nursing experience
• At least 1 year of Utilization Management experience in concurrent review or prior authorization
• Commitment to attend a mandatory 3-week training with 100% participation