Utilization Management Nurse Consultant – Weekend

Job Description: • Utilize clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members • Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care • Communicates with providers and other parties to facilitate care/treatment • Identifies members for referral opportunities to integrate with other products, services and/or programs • Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization • Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function Requirements: • 3+ years of experience as a Registered Nurse • Must have active current and unrestricted RN licensure in state of residence • 1+ years of clinical experience in acute or post acute setting • Must be willing and able to obtain additional Nursing Licenses as business needs require • Willing and able to work four 10hr-shifts including every Weekend, Saturday and Sunday, and two weekday shifts of 10hrs each Benefits: • Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs • Confidential counseling and financial coaching • Paid time off • Flexible work schedules • Family leave • Dependent care resources • Colleague assistance programs • Tuition assistance • Retiree medical access • Other benefits depending on eligibility Apply tot his job