Utilization Management Nurse

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