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Shearwater CPO® - Home of Clinicians is seeking a USRN Utilization Management Nurse to conduct medical necessity reviews for various treatment plans. This role is crucial in ensuring compliance with client's guidelines while providing quality care to injured employees.
The ideal candidate must have an active US Nursing License, preferably from New Jersey, and at least a year of recent bedside care experience. Additional skills include strong communication, organizational, time management, and interpersonal abilities.
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Terms and conditions apply.(*)
The USRN Utilization Management Nurse role is responsible in performing medical necessity review of proposed prospective, concurrent, and retrospective cases such as medical treatments, auto-injury related request, hospitalization, home care, and inpatient/outpatient treatment plans for medical necessity and efficiently in accordance with the client's-specific contract rules and guidelines and with company's policies, practices and procedures to facilitate quality and cost effective care for the injured employee.