State Licensed RN Utilization Management

A company is looking for an RN Utilization Management remote.

Key Responsibilities

Participates in designated committees and task forces related to the Utilization Management Program

Coordinates with various departments and staff regarding case management issues

Documents and communicates quality concerns related to members to appropriate staff

Required Qualifications

Associate or Bachelor's Degree in Nursing

Current license to practice as a Registered Nurse in the home state or a compact nursing license

5-7 years of clinical nursing experience, with at least 2 years in utilization review or case management

Experience in an HMO insurance setting is preferred

Ability to analyze and report on medical utilization and audit results