Remote RN Utilization Management Coordinator – Wisconsin

Network Health; Menasha (WI); Hybrid; USD 65,000 - 85,000; Full time

Job summary

Network Health in Menasha is seeking an RN Coordinator for Utilization Management responsible for evaluating authorization requests and determining medical necessity. The ideal candidate must hold a current Wisconsin RN license and have at least four years of clinical experience.

This role requires strong communication skills and knowledge of utilization management. The position is full-time with a work schedule of 40 hours per week, Monday through Friday, and involves occasional travel to the corporate office during training.

Qualifications

• Bachelor of Science in Nursing is preferred.
• Current registered nurse licensure in Wisconsin is required.
• Minimum of four years of clinical health care experience as a Registered Nurse is essential.

Responsibilities

• Evaluate and process prior authorization requests.
• Provide education regarding utilization management activities.
• Collaborate with other departments to improve operational processes.

Skills

Clinical assessment skills

Utilization management knowledge

Communication skills

Knowledge of insurance processes

Education

Bachelor of Science in Nursing

Associate Degree in Nursing

Job description

Network Health in Menasha is seeking an RN Coordinator for Utilization Management responsible for evaluating authorization requests and determining medical necessity. The ideal candidate must hold a current Wisconsin RN license and have at least four years of clinical experience.

This role requires strong communication skills and knowledge of utilization management. The position is full-time with a work schedule of 40 hours per week, Monday through Friday, and involves occasional travel to the corporate office during training.