RN Utilization Management Consultant

Job Summary

A company is looking for a Utilization Management Nurse Consultant specializing in Medical Review (Remote).

Key Responsibilities

• Utilizes clinical experience to implement, coordinate, monitor, and evaluate medical review cases
• Applies clinical criteria and guidelines to make medical determinations for clients
• Assists in training new nurse reviewers and cross-trains to perform various case reviews

Required Qualifications

• Active, unrestricted RN license with multistate/compact licensure privileges
• Minimum of 3 years of clinical experience
• 5 years of experience making independent clinical decisions
• 1+ year of experience in Utilization Review Management and/or Medical Management
• Commitment to a mandatory 3-week training program