Job Summary
A major healthcare, dental, life insurance, and medical services provider is seeking a Telecommuting Outpatient Utilization Management Registered Nurse Consultant.
Must be able to:
- Utilize clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate healthcare options to facilitate appropriate benefits
- Gather clinical information and apply the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation
- Consult with other internal and external constituents in the coordination and administration of the utilization/benefit management
Skills and Requirements Include:
- Ability to travel to New Albany, OH for a two-week training upon hire
- Utilization Management (UM) experience
- A minimum of 3-5 years of clinical experience
- An active unrestricted RN License
- Ability to work the hours of 11:30 am - 8 pm ET
- The minimum level of education desired for candidates in this position is a Associate's degree or equivalent experience
