Virginia Licensed Utilization Management Nurse

Job Summary

Virginia Licensed Utilization Management Nurse, responsible for applying clinical criteria for precertification in a full-time role that may require evening and weekend hours.

Key Responsibilities

• Collect and review clinical information from providers to authorize procedures/services
• Utilize critical thinking and evidence-based guidelines for service precertification
• Initiate Medical Director referrals as needed based on clinical assessments

Required Qualifications

• Active, current, and unrestricted RN licensure in Virginia or multi-state compact licensure
• 3+ years of clinical experience
• Proficiency with computer skills and navigating multiple systems
• Ability to work in a fast-paced environment
• Associates degree required; BSN preferred