Registered Nurse Utilization Management

Job Summary

Leveraging clinical expertise in a dynamic environment, the full-time Registered Nurse Utilization Management will assess, plan, and coordinate healthcare services for members while working remotely and requiring flexibility for evenings, weekends, and holidays.

Key responsibilities

• Utilizes clinical skills to assess and implement healthcare service options for members
• Gathers clinical information to render coverage determinations based on guidelines and clinical judgment
• Communicates with providers to facilitate care and identifies referral opportunities for members

Required qualifications

• Active, unrestricted RN license in the state of residence
• 2+ years of RN experience in adult acute care or critical care settings
• Associate Degree in Nursing required; BSN preferred