Utilization Management Nurse Consultant – Specialty Medications

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

📋 Description

• Utilize clinical judgment and evidence-based standards to assess both inpatient and outpatient services.

• Work collaboratively with healthcare providers to authorize care, ensuring precise documentation is maintained.

• Participate in occasional on-call rotations, which may include weekends and holidays.

• Conduct clinical assessments via phone and work with healthcare providers to collect essential information.

• Efficiently navigate various computer systems while ensuring the accuracy of documentation.

• Provide flexible coverage for other Utilization Management Nurses when necessary.

⛳️ Requirements

• Must possess an active and unrestricted Registered Nurse license in the state of residence.

• A minimum of 1 year of experience in the prior authorization of injectable or infused specialty medications.

• At least 5 years of relevant nursing experience is required.

• A minimum of 1 year of experience in Utilization Management, specifically in concurrent review or prior authorization.

• Strong decision-making abilities and clinical judgment in independent situations.

• Proficient in using phone systems, clinical documentation tools, and navigating various digital platforms.

• Willingness to commit to a mandatory 3-week training session (Monday–Friday, 8:30am–5:00pm EST) with full participation required.

🏝️ Benefits

• Medical, dental, and vision insurance coverage.

• Paid time off benefits.

• Options for retirement savings.

• Wellness program offerings.