Utilization Management Nurse Consultant
Core
Review clinical information and apply evidence-based criteria to make coverage recommendations for healthcare services.
Role type
Utilization Management Nurse Consultant (RN)
Builds
Coverage decisions and care coordination programs
Domain
Healthcare / Utilization Management
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure | physical/clinical work
Required skills
Clinical expertise in adult acute or critical care, Evidence-based criteria application, Care coordination, System management, Multitasking
Preferred skills
Medical-Surgical or specialty care experience, Managed Care experience, BSN degree
Responsibilities
Review clinical information to make coverage recommendations, Collaborate with healthcare providers to support quality outcomes, Identify opportunities for care coordination, Manage multiple systems and priorities
Seniority
Mid-level, hands-on IC