Registered Nurse Utilization Consultant

VirtualVocations; Columbus (OH); Remote; USD 70,000 - 90,000; Full time

Job summary

A leading company is seeking a Utilization Management Nurse Consultant to assess and coordinate healthcare services for members. The ideal candidate will have an active RN license, significant nursing experience, and the ability to work flexible hours. This role is critical in ensuring effective healthcare delivery and requires strong communication and assessment skills.

Qualifications

• Active RN licensure in the state of residence.
• At least 3 years of experience as a Registered Nurse.
• At least 1 year of clinical experience in an acute or post-acute setting.

Responsibilities

• Assess, plan, implement, coordinate, monitor, and evaluate healthcare services.
• Gather clinical information for coverage determinations.
• Communicate with providers and facilitate care.

Skills

Assessment

Coordination

Communication

Education

Associate's Degree in Nursing

Bachelor of Science in Nursing (BSN)

Job description

A company is seeking a Utilization Management Nurse Consultant. Key Responsibilities include:

1. Assess, plan, implement, coordinate, monitor, and evaluate healthcare services and benefits for members.
2. Gather clinical information to make coverage determinations and recommendations.
3. Communicate with providers, facilitate care and treatment, and identify referral opportunities.

Required Qualifications:

• Active, current, and unrestricted RN licensure in the state of residence.
• At least 3 years of experience as a Registered Nurse.
• At least 1 year of clinical experience in an acute or post-acute setting.
• Ability to work Monday through Friday, 8:00 am to 5:00 pm EST, including late-night rotations and weekends.
• Minimum of an Associate's Degree in Nursing; a BSN is preferred.