RN Utilization Management Nurse — Optimize Care & Costs

Le CYR Consulting; Fort Carson (CO); On-site; USD 60,000 - 80,000; Full time

Job summary

A healthcare consulting firm is seeking a Registered Nurse for Utilization Management. This role involves conducting reviews to ensure medical necessity of services, collaborating with healthcare providers, and analyzing utilization data. Ideal candidates must possess a nursing degree, licensing, and experience in utilization management and clinical nursing. Strong analytical and communication skills are essential. The position is based in Fort Carson, Colorado, with a schedule from Monday to Friday.

Qualifications

• Minimum of 1 year of Utilization Review/Management experience.
• Minimum of 3 years of clinical nursing experience.
• Current, full, active, unrestricted RN license in a U.S. jurisdiction; BLS certification required.

Responsibilities

• Conduct utilization management reviews to ensure healthcare services are medically necessary.
• Act as a liaison with providers and TRICARE contractors to ensure appropriate care.
• Prepare and analyze reports on utilization data and healthcare trends.

Skills

Analytical skills

Communication skills

Organizational skills

Education

Graduate of an accredited school of nursing (BSN preferred)

Job description

A healthcare consulting firm is seeking a Registered Nurse for Utilization Management. This role involves conducting reviews to ensure medical necessity of services, collaborating with healthcare providers, and analyzing utilization data. Ideal candidates must possess a nursing degree, licensing, and experience in utilization management and clinical nursing. Strong analytical and communication skills are essential. The position is based in Fort Carson, Colorado, with a schedule from Monday to Friday.