South Carolina Licensed Utilization Nurse - job 1 of 2

Job Summary

A company is looking for a Utilization Management Nurse II.

Key Responsibilities

• Conduct utilization reviews to ensure appropriate patient care and treatment intensity
• Monitor patient charts and treatment plans, and consult with multidisciplinary teams as needed
• Ensure compliance with regulatory requirements and facilitate accurate reimbursement for hospital resources

Required Qualifications

• Bachelor's degree in Nursing from an accredited institution
• Five years of nursing experience, including two years in utilization or case management within a hospital setting
• Licensure as a registered nurse in South Carolina or a compact state
• Evidence of committee involvement in a healthcare setting
• Prior leadership experience preferred