Remote Utilization Management Nurse Specialist

Ampcus, Inc; Owings Mills (MD); On-site; USD 70,000 - 90,000; Full time

Job summary

Ampcus, Inc is seeking a Utilization Management Specialist to perform medical necessity reviews and ensure appropriate care within the healthcare system. The role involves utilizing clinical expertise to analyze information and contribute to the authorization of clinical services.

Candidates should have a Bachelor’s in Nursing, extensive clinical nursing experience, and strong communication skills. The position is remote and offers a dynamic work environment.

Qualifications

• 5 years of clinical nursing experience.
• 2 years of care management experience.
• RN/LPN state licensing or compact required.

Responsibilities

• Determine medical necessity and appropriateness by referencing regulatory mandates.
• Conduct research and analysis of pertinent diseases and treatments.
• Make appropriate referrals and offer assistance to members.

Skills

Clinical nursing experience

Care management experience

Effective communication skills

Web-based technology proficiency

Education

Bachelor's Degree in Nursing

Tools

Microsoft Office

Job description

Ampcus, Inc is seeking a Utilization Management Specialist to perform medical necessity reviews and ensure appropriate care within the healthcare system. The role involves utilizing clinical expertise to analyze information and contribute to the authorization of clinical services.

Candidates should have a Bachelor’s in Nursing, extensive clinical nursing experience, and strong communication skills. The position is remote and offers a dynamic work environment.