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Utilization Management Nurse Consultant

Company: VirtualVocations
Location: South Bend
Posted on: October 23, 2024

Job Description:

A company is looking for a Utilization Management Nurse Consultant to work remotely in a clinical telephone queue.



Key Responsibilities

Utilize clinical skills to coordinate and communicate aspects of the utilization/benefit management program
Gather clinical information and apply appropriate criteria to render determinations for prior authorization reviews
Identify members for referral opportunities and promote quality effectiveness of healthcare services


Required Qualifications

5+ years of clinical experience required
Current unrestricted RN licensure in the state of residence
5 years of experience making independent clinical decisions
Proficient use of phone, computer, and clinical documentation systems
Associate Degree in Nursing required; BSN preferred

Keywords: VirtualVocations, Des Plaines , Utilization Management Nurse Consultant, Executive , South Bend, Illinois

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