State Licensed Nurse Consultant

A company is looking for a Utilization Management Nurse Consultant.

Key Responsibilities

Apply clinical judgment and evidence-based criteria to evaluate inpatient and outpatient services

Conduct clinical reviews and collaborate with healthcare providers to gather necessary information

Authorize services or escalate cases to Medical Directors as needed while maintaining accurate documentation

Required Qualifications

Active unrestricted state Registered Nurse licensure in state of residence

Minimum 5 years of relevant experience in Nursing

At least 1 year of Utilization Management experience in concurrent review or prior authorization

Proficient with phone systems and clinical documentation tools

Commitment to attend a mandatory 3-week training with 100% participation