Utilization Management Nurse Consultant

The Muse - Dover, DE

Job Title: Utilization Management Nurse Consultant

Position: Utilization Management Nurse

Job Type: Full Time

Pay: $26.01 - $74.78

Shift: 24/7 operation including weekends, holidays, and evening hours

Work Type:

Address:

City: Dover

State: DE

ZIP Code:

Utilizes clinical experience in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate healthcare services/benefits for members.
Gathers clinical information and applies appropriate clinical criteria/guideline, policy, procedure, and clinical judgment to render coverage determination/recommendation.
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.

Proficiency with computer skills including navigating multiple systems and keyboarding
Effective communication skills, both verbal and written
Ability to multitask and prioritize in a fast-paced changing environment

Experience: 2+ years as a Registered Nurse in adult acute care/critical care setting

Education: Associates Degree required, BSN preferred

License & Certification:

Schedule:

COVID-19 Requirements: Not Specified

Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Commitment to fostering a workplace where every colleague feels valued and that they belong.