Utilization Management RN: Care & Compliance (Mon-Fri)

Cooperidge Consulting Firm; Haughton (LA); On-site; USD 67,000 - 92,000; Full time

Benefits offered by this job

Health Care Plan (Medical, Dental & Vision)

Retirement Plan (401k, IRA)

Life Insurance (Basic, Voluntary & AD&D)

Paid Time Off (Vacation, Sick & Public Holidays)

Family Leave (Maternity, Paternity)

Short Term & Long Term Disability

Training & Development

Wellness Resources

Annual CME Stipend and License/Certification Reimbursement

Job summary

A consulting firm in the health sector is seeking an experienced Registered Nurse (RN) specializing in Utilization Management (UM) to join the team. This role involves conducting clinical reviews, collaborating with healthcare providers, and ensuring compliance with quality standards. The ideal candidate will have a strong clinical background, excellent communication skills, and the ability to work effectively in a team environment. Benefits include comprehensive health coverage, retirement plans, and ongoing training and development.

Qualifications

• Minimum of 3 years of clinical nursing experience, with at least 1 year in Utilization Management or Utilization Review.
• Certification in Utilization Review or Case Management preferred.
• Must possess ability to pass a Government background check/security clearance.

Responsibilities

• Conduct comprehensive reviews of clinical records for appropriateness and necessity of care.
• Collaborate with healthcare teams to ensure coordinated patient care.
• Facilitate care transitions and discharge planning processes.
• Monitor healthcare services for compliance with regulations.
• Educate patients and families about care management processes.

Skills

Analytical skills

Critical thinking

Communication skills

Interpersonal skills

Teamwork

Education

ASN degree from an accredited college or university

AHA or ARC BLS Certification

Job description

A consulting firm in the health sector is seeking an experienced Registered Nurse (RN) specializing in Utilization Management (UM) to join the team. This role involves conducting clinical reviews, collaborating with healthcare providers, and ensuring compliance with quality standards. The ideal candidate will have a strong clinical background, excellent communication skills, and the ability to work effectively in a team environment. Benefits include comprehensive health coverage, retirement plans, and ongoing training and development.