Remote Utilization Management Nurse Consultant

Job Summary

A company is looking for a Utilization Management Nurse Consultant, a fully remote position open to candidates in any state, focused on coordinating, documenting, and communicating all aspects of the utilization/benefit management program.

Key Responsibilities

• Review services to assure medical necessity and appropriate benefit utilization, and facilitate safe and efficient discharge planning
• Utilize clinical skills to coordinate, document, and communicate all aspects of the utilization/benefit management program
• Identify members for referral opportunities to integrate with other products, services, and/or programs and promote quality effectiveness of Healthcare Services

Required Qualifications and Education

• Must have an active, current, and unrestricted RN licensure in the state of residence
• 2+ years of acute hospital clinical experience as an RN with a preference for medical-surgical and ICU experience
• 1+ years' experience with Microsoft Office Suite (PowerPoint, Word, Excel, Outlook)
• Ability to work specified hours including a late shift until 9:00pm EST on a rotating basis and a rotating weekend shift requirement
• Associates Degree required; BSN preferred