Utilization Management Nurse Consultant

Role Overview

• Review and assess clinical information using established guidelines and criteria
• Make coverage determinations across the continuum of care
• Collaborate with providers and internal partners to coordinate care
• Identify opportunities to improve care quality and utilization outcomes
• Refer members to programs and services that support better health outcomes
• Serve as a clinical resource for internal and external stakeholders

Requirements

• Active, unrestricted RN license in state of residence
• 3+ years of RN experience
• 1+ year of Med/Surg experience
• Proficiency with Microsoft Office (Outlook, Teams, Excel)
• Associate’s degree in nursing (BSN preferred)

Benefits

• medical coverage
• dental coverage
• vision coverage
• paid time off
• retirement savings options
• wellness programs