Utilization Review Nurse

Job Summary

A company is looking for a Utilization Review Nurse.

Key Responsibilities:

• Perform clinical assessments and evaluate treatment utilization and compliance
• Collaborate with various parties to negotiate appropriate levels of care
• Conduct treatment utilization management reviews and maintain client confidentiality

Qualifications:

• Active unrestricted RN license in a state or territory of the United States
• Bachelor's degree in nursing or equivalent work experience preferred
• Certification in case management, pharmacy, rehabilitation nursing, or related specialty highly preferred
• Two years of direct clinical experience as an RN required
• Experience in managing complex medical conditions and treatment planning