Utilization Review Nurse - RN

We're Hiring: Utilization Review Nurse - RN!

We are seeking a dedicated and experienced Utilization Review Nurse (RN) to join our team. The ideal candidate will possess clinical expertise and a strong understanding of healthcare regulations to ensure optimal patient care while managing resource utilization effectively.

Location: Albuquerque, NM - 100% remote - but may need to be onsite for occasional meetings

Role: Utilization Review Nurse - RN

Pay rate: $40/hr. on W2, no benefits

Description

This position is responsible for performing concurrent review in accordance with accepted department criteria; performing discharge planning and identifying alternate treatment programs; conducting episodic case management, consulting and collaborating with providers, members, and other resources as appropriate; assessing, planning, and implementing options and services require to meet an individuals health needs within the scope of their benefit plan.

Job Requirements

• Register Nurse (RN) with current, valid, unrestricted license in state of operations or reciprocity.
• 3 years of clinical experience
• Experience utilizing various software packages
• Verbal and written communication skills
• Analytical skills- Incumbents with nursing licenses in positions/departments requiring multi-state licenses are required to obtain and maintain additional current, valid, and unrestricted applicable nursing licenses in other states as determined by management.
• Multi-state license fees will be provided by the client.
• Incumbents with other clinical licenses are not required to obtain multi-state licenses.
  
  

Preferred Job Requirements

• Familiarity with UM/CM activities and standardized criteria set.
• Knowledge of ancillary services including HHC, SNF, Hospice, etc.
• Training is completed through Microsoft Teams precepting. Worker should be able to hit the ground running.
  
  

Ready to make an impact? Apply now and let’s grow together!