Utilization Management Nurse Consultant

This is a fully remote position, open to applicants in United States.

📋 Description

• Assess clinical data and utilize evidence-based guidelines to make decisions on coverage.

• Work in partnership with healthcare providers and care teams to facilitate services and enhance treatment plans.

• Recognize opportunities to enhance care quality, operational efficiency, and member outcomes.

• Link members to supplementary programs and resources.

• Act as a clinical resource for both internal and external stakeholders.

⛳️ Requirements

• Current, unrestricted RN license in the state of residence (mandatory).

• Minimum of 2 years of experience in adult acute or critical care.

• Excellent clinical judgment, communication abilities, and multitasking skills.

• Ability to thrive in a fast-paced, technology-oriented setting.

• Associate's Degree in Nursing is preferred.

• Experience in Med-Surg or specialty clinical areas.

• Background in managed care or Utilization Management is advantageous.

• BSN is preferred.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources based on eligibility.