RN Utilization Review
Location: Remote
Compensation: To Be Discussed
Reviewed: Thu, Jul 03, 2025
This job expires in: 26 days
Job Summary
A company is looking for an RN Utilization Review.
Key Responsibilities
- Participates in designated committees and task forces related to the Utilization Management (UM) Program
- Coordinates with various departments and medical staff on case management issues
- Documents and communicates quality concerns related to members to the Quality Management staff
Required Qualifications
- Associate or Bachelor's Degree in Nursing
- Current license to practice as a Registered Nurse in the home state or a compact nursing license
- 5-7 years of clinical nursing experience, with at least 2 years in utilization review or case management
- Experience in an HMO insurance setting is preferred
- Ability to analyze and report on medical utilization and audit results
COMPLETE JOB DESCRIPTION
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