Utilization Management Nurse Consultant – Weekends, 4-10 Hour Shifts
Job Description:
- Review and assess clinical information to support coverage determinations
- Apply clinical guidelines, policies, and sound judgment across the care continuum
- Collaborate with providers and care teams to coordinate treatment plans
- Identify opportunities to enhance quality, efficiency, and member outcomes
- Refer members to additional programs and services as appropriate
- Serve as a clinical resource within utilization/benefit management
Requirements:
- Active, unrestricted RN license in state of residence
- 3+ years of RN experience
- 1+ year Med/Surg experience
- Proficiency with Microsoft Office (Outlook, Teams, Excel)
- Willingness to work required schedule post-training
- Prior Authorization or Utilization Management experience preferred
- Managed care experience preferred
- MedCompass experience preferred
- Ambulatory surgery background preferred
- BSN preferred (Associate’s required)
Benefits:
- medical, dental, and vision coverage
- paid time off
- retirement savings options
- wellness programs
- other resources, based on eligibility