Utilization Management Registered Nurse Consultant (Remote)

Position Summary

Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours.

• Utilizes clinical experience and skills to assess, plan, implement, coordinate, monitor and evaluate healthcare services/benefits.
• Gathers clinical information and applies appropriate clinical criteria/guidelines to render coverage determinations.
• Communicates with providers and other parties to facilitate care/treatment.
• Consults and lends expertise in the coordination and administration of the utilization/benefit management function.

Required Qualifications

• 2+ years of experience as a Registered Nurse in adult acute care/critical care setting
• Active current and unrestricted RN licensure in state of residence

Preferred Qualifications

• 2+ years of clinical experience in med surg or specialty area
• Managed Care experience, especially Utilization Management