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CategoryHealthcare
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No of Jobs1
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Apply Before09/22/2025
Description
Utilization Management Nurse Consultant
The Muse - Montgomery, AL
Job Title: Utilization Management Nurse Consultant
Position: Utilization Management Nurse
Job Type: Full time
Pay: $26.01 - $68.55
Shift: 24/7 operation, weekends, holidays, and evening hours
Work Type: On-Site
Location
Address:
City: Montgomery
State: AL
ZIP Code:
Job Responsibilities
- Utilizes clinical experience and skills 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 internal and external constituents in the coordination and administration of the utilization/benefit management function.
- Works in a typical office environment with productivity and quality expectations.
- Requires close inspection of handwritten and computer-generated documents.
- Perform sedentary work including sitting for extended periods, talking on the telephone, and typing on the computer.
- Ability to multitask, prioritize, and adapt to a fast-paced changing environment.
- Requires proficiency with computer skills, including navigating multiple systems and keyboarding.
- Effective communication skills, both verbal and written.
Required Skills
Core Skills
- Clinical experience in adult acute care/critical care setting
- Active RN licensure in state of residence
- Proficiency in computer skills and keyboarding
- Effective verbal and written communication
Preferred Skills
- 2+ years of clinical experience in med surg or specialty area
- Managed Care experience, especially in Utilization Management
- Preference for those residing in central zones
Requirements
Experience: 2+ years of experience as a Registered Nurse in adult acute care/critical care setting
Education: Associates Degree required, BSN preferred
License & Certification:
- Active current and unrestricted RN licensure in state of residence
Schedule:
- 24/7 operation including weekends, holidays, and evening hours
COVID-19 Requirements: Not Specified
Benefits
- Affordable medical plan options
- 401(k) plan (including matching company contributions)
- Employee stock purchase plan
- No-cost wellness screenings, tobacco cessation, and weight management programs
- Confidential counseling and financial coaching
- Flexibility benefits including paid time off, flexible work schedules, family leave, dependent care resources, and colleague assistance programs
- Tuition assistance
- Retiree medical access
Supplemental Pay
- CVS Health bonus, commission or short-term incentive program
Special Notes
- Commitment to fostering a workplace where every colleague feels valued and belongs.
- Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws.
Facility Details
Name: The Muse
Description: The nation's leading health solutions company reaching millions through local presence and digital channels.
Specialties:
- Health solutions
- Healthcare services
Mission: Building a world of health around every consumer.
Job Info
Discipline:
Department:
Status:
Sourcing
Duration:
Experience:
Career Level:
No of Jobs:
1
Apply Before:
09/22/2025
Posted:
06/22/2025
