Utilization Management RN - Physical Health
Core
Utilization Management RN using clinical nursing skills to coordinate, document, and communicate medical services and benefit administration determinations for enrollees.
Role type
Utilization Management Registered Nurse
Builds
Medical service coordination and benefit administration determinations
Domain
Healthcare / Health Insurance
Required skills
Clinical nursing judgment, Microsoft Excel, Microsoft Outlook, weekend shift availability
Preferred skills
Utilization Management experience, EPIC Programs experience, remote work experience
Responsibilities
Interpret criteria and procedures to determine appropriate treatment and care; Coordinate and communicate with providers and enrollees to facilitate optimal care; Follow established guidelines and procedures; Travel occasionally to the Oklahoma City office for meetings and training