Registered Nurse Utilization Consultant

VirtualVocations; Peoria (AZ); Remote; USD 70,000 - 90,000; Full time

Job summary

A leading healthcare company is seeking a Utilization Management Nurse Consultant to assess and coordinate healthcare services for members. This role requires active RN licensure and several years of nursing experience. The consultant will be responsible for gathering clinical information and facilitating care, ensuring optimal service delivery. Ideal candidates should possess strong assessment and communication skills, with a preference for those holding a BSN.

Qualifications

• Active RN licensure in state of residence.
• 3+ years of experience as a Registered Nurse.
• 1+ year of clinical experience in acute/post-acute setting.

Responsibilities

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

Skills

Assessment

Communication

Coordination

Clinical Evaluation

Education

Associate's Degree in Nursing

Bachelor of Science in Nursing (BSN)

Job description

A company is looking for a Utilization Management Nurse Consultant.

Key Responsibilities

1. Assess, plan, implement, coordinate, monitor, and evaluate healthcare services/benefits for members.
2. Gather clinical information to render coverage determinations and recommendations.
3. Communicate with providers and facilitate care/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.
• Minimum of 1 year of clinical experience in an acute or post-acute setting.
• Ability to work Monday - Friday, 8:00 am - 5:00 pm EST, with late-night rotation and weekends.
• Minimum of an Associate's Degree in Nursing; BSN preferred.