Registered Nurse Utilization Consultant
VirtualVocationsCranston, Rhode Island, United Statesjob_description.job_card.30_days_ago
serp_jobs.job_preview.job_type
- serp_jobs.job_card.full_time
job_description.job_card.job_description
A company is looking for a Utilization Management Nurse Consultant - Remote.
Key Responsibilities
Evaluate outpatient and inpatient services requiring precertification using clinical criteria
Conduct clinical reviews and collaborate with healthcare providers to gather necessary information
Authorize services or escalate 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 a mandatory 3-week training with 100% participation
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Registered Nurse • Cranston, Rhode Island, United States
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