Utilization Management Nurse Reviewer

Job Summary

A company is looking for a Utilization Management Nurse Reviewer for a weekend shift.

Key Responsibilities

• Conduct assessments of medical services to validate appropriateness and necessity
• Examine patient records to verify quality of care and necessity of services
• Collaborate with management teams, physicians, and the Medical Director to optimize patient care

Required Qualifications, Training, and Education

• Licensed Practical/Vocational Nurse with an active and unrestricted license or a nursing degree from an accredited college
• Minimum of 2 years of clinical nursing experience
• At least 1 year of previous experience in Utilization Management
• Proficient in Microsoft tools such as Word, Excel, PowerPoint, and Outlook
• Knowledge of regulatory prerequisites for utilization review