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CategoryHealthcare
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No of Jobs1
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Apply Before09/10/2025
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 - $74.78
Shift: 24/7 operation including weekends, holidays and evening hours
Work Type:
Location
Address:
City: Montgomery
State: AL
ZIP Code:
Job Responsibilities
- Utilizes 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.
- Maintains productivity and quality expectations in a typical office working environment.
Required Skills
Core Skills
- Clinical experience in acute care/critical care settings
- Proficiency in computer skills including navigating multiple systems
- Effective verbal and written communication skills
- Ability to multitask and adapt in a fast-paced environment
Preferred Skills
- 2+ years of clinical experience in med surg or specialty area
- Managed Care experience, especially in Utilization Management
- Preference for candidates residing in EST and CST 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 with matching company contributions
- Employee stock purchase plan
- No-cost 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
Supplemental Pay
- Eligible for bonus, commission, or short-term incentive program in addition to base pay
Special Notes
- Diversity and inclusion: We are committed to fostering a workplace where every colleague feels valued and that they belong.
- 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: Leading health solutions company reaching millions of Americans with dedicated colleagues.
Specialties:
- Healthcare
Mission: Building a world of health around every consumer with compassion and connectivity.
Job Info
Discipline:
Department:
Status:
Sourcing
Duration:
Experience:
Career Level:
No of Jobs:
1
Apply Before:
09/10/2025
Posted:
06/10/2025
