A company is looking for a Utilization Management Nurse Consultant.
Key Responsibilities
Assess, plan, implement, coordinate, monitor, and evaluate healthcare services / benefits for members
Gather clinical information to render coverage determinations and facilitate care / treatment
Consult with internal and external parties to enhance utilization and benefit management functions
Required Qualifications
Registered Nurse with active and unrestricted RN licensure in the state of residence
May need to obtain additional Nursing Licenses as required by business needs
1+ years of Managed Care Experience preferred
1+ years of clinical experience in an acute or post-acute setting preferred
Diploma RN acceptable; Associate degree / BSN preferred
Licensed Licensed • Hamilton, New Jersey, United States