Utilization Management Registered Nurse

Candidates must possess an active enhanced Registered Nurse (eNLC) license with no disciplinary action and the ability to obtain multiple state registered nurse licenses. A minimum of three years of nursing experience in Medical Surgery, Heart, Lung, maternity/obstetrics, or Critical Care is required, along with prior clinical experience in an acute care, skilled, or rehabilitation setting. Intermediate to advanced knowledge of Microsoft Word, Outlook, and Excel, systems, and platforms is necessary, as is the ability to work independently and as part of a team. A Bachelor's degree, previous experience in prior authorization, claims, or utilization management, health plan experience, and Medicare/Medicaid experience are preferred. Bilingual skills are a plus. Candidates must reside in a state that participates in the enhanced nurse licensure (eNLC) and have a reliable internet connection with at least 25 Mbps download and 10 Mbps upload speeds.