Utilization Management Nurse Consultant

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 of 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