A company is looking for a Utilization Management Nurse Consultant specializing in Medical Review (Remote).
Key Responsibilities
Implement, coordinate, monitor, and evaluate medical review cases using clinical expertise
Render medical determinations based on clinical criteria and guidelines
Assist in training new nurse reviewers and recommend process improvements
Required Qualifications
Active, unrestricted RN license with multistate / compact licensure privileges
Minimum 3 years of clinical experience
5 years of experience making independent clinical decisions
1+ year of Utilization Review Management and / or Medical Management experience
Commitment to a mandatory 3-week training program
Utilization Management Nurse • Fort Lauderdale, Florida, United States