Texas Licensed Utilization Management RN

A company is looking for a Fertility Utilization Management RN - Remote.

Key Responsibilities

Determine the appropriateness of inpatient and outpatient services based on medical guidelines and benefit determination

Identify solutions to non-standard requests and problems while acting as a resource for others

Work autonomously on complex issues, making decisions that directly impact members' health outcomes

Required Qualifications

Current unrestricted RN licensure in state of residence

Compact license and / or willingness to obtain additional licenses in specified states

3+ years of Managed Care and / or Clinical experience

1+ years of fertility experience

Proven computer proficiency, including strong data entry skills and navigation in a Windows environment