Registered Nurse Consultant

Job Summary

Registered Nurse Consultant provides full-time professional nursing care remotely, focusing on assessment, planning, and evaluation to enhance member experience and ensure effective healthcare services.

Key Responsibilities

• Evaluate member health metrics to develop and implement targeted initiatives and programs
• Assess member needs for Care Management or Utilization Management interventions
• Collaborate with members and providers to address healthcare needs and promote health plan benefits

Required Qualifications

• Bachelor of Science in Nursing (BSN) with 4-6 years of relevant experience
• Active RN license in good standing, eligible for licensure in all US states and territories
• Experience in health plan and/or payer systems preferred
• Clinical proficiency with case management or utilization management experience preferred
• Relevant certifications in case management or utilization management are a plus