South Carolina Licensed Utilization Nurse - job 1 of 3

Job Summary

A company is looking for a Utilization Management Nurse for Behavioral Health (Remote) position.

Key Responsibilities

• Conduct utilization reviews to assess the appropriateness of patient care based on illness severity and service intensity
• Monitor patient charts and treatment plans, ensuring compliance with applicable policies and regulations
• Consult with healthcare providers and stakeholders as necessary to facilitate patient care

Required Qualifications, Training, and Education

• Bachelor's degree in Nursing from an accredited institution
• Five years of nursing experience, including two years in utilization or case management in a hospital setting
• Preferred prior leadership experience and evidence of committee involvement in a healthcare setting
• Licensure as a registered nurse in South Carolina or a compact state
• Familiarity with InterQual and/or MCG screening criteria is desired