Utilization Management Nurse

Job is Expired
Location: Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin, Wyoming
Compensation: To Be Discussed
Staff Reviewed: Fri, Aug 25, 2023

Job Summary

A company is looking for a Utilization Management Nurse 2 for a weekend position.

Key Responsibilities:
  • Utilize clinical nursing skills to support coordination, documentation, and communication of medical services and benefit administration determinations
  • Interpret criteria, policies, and procedures to provide the best and most appropriate treatment, care, or services for members
  • Coordinate and communicate with providers, members, or other parties to facilitate optimal care and treatment
Required Qualifications:
  • Active RN license with no disciplinary action, preferably compact state license
  • Clinical experience in an acute care, skilled or rehabilitation setting
  • Experience in utilization management or related activities reviewing criteria to ensure appropriateness of care
  • Comprehensive knowledge of Microsoft Word, Outlook, and Excel
  • Ability to work independently under general instructions and with a team

COMPLETE JOB DESCRIPTION

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