Registered Nurse Utilization Consultant

Job Summary

A company is looking for a Utilization Management Nurse Consultant - Medical Review (Remote).

Key Responsibilities

• Perform medical necessity reviews and quality assurance audits for healthcare services
• Collaborate with healthcare providers and multidisciplinary teams to optimize patient outcomes
• Develop and implement utilization management strategies and policies to improve patient care quality

Required Qualifications, Training, and Education

• Active unrestricted state Registered Nurse licensure in state of residence
• Minimum 5 years of relevant nursing experience
• 2-3 years of experience in Utilization Management, Medical Review, or Case Management
• 5 years of clinical experience in various healthcare settings
• Bachelor's degree preferred or specialized training in a relevant field