Join our caring community as a Utilization Management Registered Nurse, where your clinical skills will help coordinate optimal care for our members. Make a meaningful impact in healthcare by ensuring the best treatment and services are provided.
Key Responsibilities
Utilize clinical nursing skills for coordination and documentation of medical services
Interpret criteria, policies, and procedures for optimal treatment
Coordinate and communicate with providers and members
Make independent decisions regarding work methods
Follow established guidelines and procedures
Required Qualifications
Licensed Registered Nurse (RN)
Compact License
3+ years of Skilled Nursing Facility experience
Prior clinical experience in acute care, skilled or rehabilitation setting
Comprehensive knowledge of Microsoft Word, Outlook and Excel
Ability to work independently and as part of a team
Passion for improving consumer experiences
Preferred Qualifications
BSN or Bachelor's degree in a related field
Health Plan experience
Previous Medicare/Medicaid Experience
Call center or triage experience
Bilingual
Benefits & Perks
Medical, dental and vision benefits401(k) retirement savings planPaid time off and holidaysVolunteer time offPaid parental and caregiver leaveShort-term and long-term disabilityLife insurance