Washington Licensed Utilization Nurse

Job Summary

A company is looking for a Utilization Management Nurse.

Key Responsibilities:

• Conducts reviews of requested healthcare services to determine medical necessity and appropriateness of inpatient services
• Collaborates with medical directors and stakeholders to ensure effective care transitions and resource availability
• Manages utilization review authorizations and responds to appeal requests within specified timeframes

Required Qualifications:

• Graduation from an accredited school of nursing
• Active, unrestricted Registered Nurse license in State of Hire
• 2+ years of experience in Utilization Review for Insurance or Community Based facility
• 2+ years of clinical nursing experience