RN Utilization Management 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 experience

Apply clinical criteria and guidelines to make medical determinations for clients

Assist in training new nurse reviewers and recommend process improvements to enhance quality and client satisfaction

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 or Medical Management experience

Commitment to a mandatory 2-week training program with full participation