Utilization Management RN

Job Summary

A company is looking for a Utilization Management RN to join their team on a remote, contract basis.

Key Responsibilities

• Perform delegated tasks within the Nurse Case Management job family
• Collaborate with physicians to plan, implement, and evaluate healthcare services
• Conduct utilization reviews for inpatient, outpatient, and rehabilitation services

Required Qualifications

• Active, unrestricted RN license in the U.S
• Minimum 2 years of Utilization Management RN experience
• Experience working for a health plan within the last 3 years
• Proficiency with Milliman Care Guidelines (MCG) or InterQual Criteria
• Strong computer literacy and comfort with digital tools