Job Summary
An independent, not-for-profit health benefits organization has a current position open for a Remote Utilization Management Registered Nurse Clinician.
Individual must be able to fulfill the following responsibilities:
- Initiate referrals to ensure appropriate coordination of care
- Assists non-clinical staff in performance of administrative reviews
- Seek the advice of the Medical Director when appropriate, according to policy
Position Requirements Include:
- 3 years - Clinical experience required
- Proficient in Microsoft Office (Outlook, Word, Excel and PowerPoint)
- Working knowledge of URAC, NCQA and CMS accreditations
- RN with active license in the state of Tennessee or hold a license in the state of their residence if the state is participating in the Nurse Licensure Compact Law
- Excellent oral and written communication skills
- Strong interpersonal and organizational skills
