Job Summary

A healthcare and retail pharmacy company needs applicants for an opening for a Remote Utilization Management Clinical Consultant Licensed Registered Nurse.

Individual must be able to fulfill the following responsibilities:

• Coordinate, document, and communicate all aspects of the utilization/benefit management program
• Apply critical thinking and knowledge in clinically appropriate treatment
• Determine evidence based care and medical necessity criteria for appropriate utilization of services

Position Requirements Include:

• Licensed Registered Nurse (RN) with active unrestricted state license
• 3 years clinical practice experience
• Able to to render coverage determination and planning along the continuum of care
• Able to coordinate with providers and other parties to facilitate optimal care/treatment