Utilization Manager, Registered Nurse

Assesses member needs and identifies solutions that promote high quality and cost-effective health care services. Manages providers, members, team, or care manager generated requests for medical services and renders clinical determinations in accordance with healthcare policies as well as applicable state and federal regulations.

Requirements

• Compact Licensed RN, California and New York State preferred
• Bachelor's degree in nursing preferred; Associate degree in nursing is minimum requirement.
• Knowledge of Medicare and Medicaid regulations
• Excellent organizational and time management skills, interpersonal skills, verbal and written communication skills.
• Working knowledge of Microsoft Excel, Power-Point, and Word and strong typing skills

Benefits

• Comprehensive, affordable insurance plans for team and their families
• Yearly stipend for wellness-related activities
• Paid parental leave program