Registered Nurse Utilization Management
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Job Summary
Working remotely in a full-time capacity, the Registered Nurse Utilization Management will review clinical information, coordinate healthcare services, and collaborate with providers to ensure members receive appropriate care.
Key responsibilities
- Review clinical information and apply guidelines to support coverage determinations
- Assess, coordinate, and evaluate healthcare services across the continuum of care
- Identify opportunities to improve quality of care and connect members with additional resources
Required qualifications
- Active, unrestricted RN license in the state of residence
- 2+ years of adult acute care and/or critical care nursing experience
- Associate Degree in Nursing required
- Strong clinical assessment and decision-making skills
- Proficiency in navigating multiple computer systems and applications
Complete Job Description
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