Utilization Management Nurse Consultant will work full-time in a fully remote capacity, utilizing clinical expertise to assess, plan, implement, and evaluate healthcare services for members while collaborating with providers and facilitating care coordination. Key responsibilities Assess and apply clinical criteria to render coverage determinations and recommendations for healthcare services Communicate with providers and other stakeholders to facilitate care and identify referral opportunities Consult on utilization management processes and promote the effective use of healthcare services Required qualifications 3+ years of experience as a Registered Nurse (RN) Active and unrestricted RN licensure in the state of residence Experience with multiple IT platforms and systems 1+ years of experience with Microsoft Office Applications (Outlook, Teams, Excel) Associates Degree in Nursing required; BSN preferred
Utilization Management Nurse Consultant in workfromhome at Unknown Company
This position is listed as full time and able to be worked remotely.