Registered Nurse Utilization Management

Job Summary

A company is looking for a Utilization Management Nurse Consultant - Fully Remote.

Key Responsibilities

• Utilize clinical skills to coordinate and document all aspects of the utilization/benefit management program
• Assess, plan, implement, coordinate, monitor, and evaluate healthcare services and benefits for members
• Communicate with providers to facilitate care and identify opportunities for quality improvement in healthcare services

Required Qualifications

• 1 year of experience in Utilization Management, concurrent review, or prior authorization
• 5 years of clinical experience
• 5 years of demonstrated ability to make independent clinical decisions
• Proficient in using clinical documentation systems and related equipment
• Must be a Registered Nurse with an unrestricted license in the state of residence