A company is looking for a Utilization Management Nurse Consultant - Work From Home.
Key Responsibilities
Utilizes clinical experience to assess, plan, implement, coordinate, monitor, and evaluate healthcare services for members
Gathers clinical information and applies clinical criteria to render coverage determinations
Communicates with providers to facilitate care and identifies members for referral opportunities
Required Qualifications
Active, current, and unrestricted compact RN licensure in state of residence
3+ years of clinical experience required
1+ years of experience with Microsoft Office Suite required
Proficiency in navigating multiple computer systems
Ability to work in a fast-paced environment
Utilization Management Rn • Lexington, Kentucky, United States