Utilization Management Nurse Reviewer

Job Summary

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

Key Responsibilities

• Conduct assessments of medical services to validate their appropriateness based on established criteria
• Examine patient records to ensure the quality of care and necessity of services provided
• Coordinate care and provide clinical expertise while communicating with healthcare providers and management teams

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 required
• At least 1 year of previous experience in Utilization Management is required
• Background in medical or clinical practice through education, training, or professional engagement
• Proficiency in Microsoft tools such as Word, Excel, and Outlook