Registered Nurse Utilization Consultant

VirtualVocations; Glendale (AZ); On-site; USD 75,000 - 95,000; Full time

Job summary

A leading company is seeking a Utilization Management Nurse Consultant to assess and coordinate healthcare services. The role involves evaluating member benefits, gathering clinical information, and facilitating care with providers. Candidates must have active RN licensure and significant nursing experience, with a preference for those holding a BSN.

Qualifications

• Active RN licensure in the state of residence.
• At least 3 years of experience as a Registered Nurse.
• Minimum of an Associate's Degree in Nursing.

Responsibilities

• Assess and evaluate healthcare services and benefits for members.
• Gather clinical information for coverage determinations.
• Communicate with providers to facilitate care and identify referrals.

Skills

Assessment

Coordination

Clinical Communication

Education

Associate's Degree in Nursing

Bachelor's Degree in Nursing (preferred)

Job description

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

1. Assessing, planning, implementing, coordinating, monitoring, and evaluating healthcare services and benefits for members.
2. Gathering clinical information to make coverage determinations and recommendations.
3. Communicating with providers and facilitating care and treatment, while identifying 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.
• Over 1 year of clinical experience in an acute or post-acute setting.
• Availability to work Monday through Friday, 8:00 am to 5:00 pm EST, with late-night rotations and weekends.
• Minimum of an Associate's Degree in Nursing; a BSN is preferred.