Job Summary

A company is looking for a Utilization Management Nurse.

Key Responsibilities:

• Conduct assessments of medical services to validate their appropriateness using established criteria and guidelines
• Examine and evaluate patient records to verify the quality of patient care and the necessity of provided services
• Offer clinical expertise and serve as a clinical reference for non-clinical staff members

Required Qualifications:

• Proficient in both written and spoken communication
• Adept at resolving intricate and multifaceted problems
• Background in medical or clinical practice through education, training, or professional engagement
• Holds an unrestricted LVN/RN license from an accredited vocational nursing program (for LVNs) or a nursing degree from an accredited college (for RNs)