RN: Clinical Utilization Review & Care Coordination

Healthcare Support Staffing; Town of Florida (NY); On-site; USD 70,000 - 90,000; Full time

Job summary

A leading healthcare staffing firm is seeking a qualified clinical nurse for a utilization management role. Candidates should possess at least 2 years of clinical nursing experience and a year in utilization management within a managed care environment. The position requires collaboration with various healthcare staff to ensure quality care and involves reviewing medical necessity. Applicants can reach out to the recruitment consultant for further details and to apply for the position.

Qualifications

• Must have 2+ years of clinical nursing experience in an acute care setting.
• 1+ years of utilization management experience is required.
• Strong knowledge of utilization management principles is essential.

Responsibilities

• Perform onsite review of emergent/urgent care requests.
• Collaborate with provider networks to coordinate member care.
• Educate providers on medical management processes.

Skills

2+ years of clinical nursing experience in an acute care setting

1+ years of utilization management experience in a managed care setting

Knowledge of utilization management principles

Experience with medical decision support tools

Education

RN, BSN preferred

Job description

A leading healthcare staffing firm is seeking a qualified clinical nurse for a utilization management role. Candidates should possess at least 2 years of clinical nursing experience and a year in utilization management within a managed care environment. The position requires collaboration with various healthcare staff to ensure quality care and involves reviewing medical necessity. Applicants can reach out to the recruitment consultant for further details and to apply for the position.