Nurse Consultant

Job Description: • Utilize 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 • Gather clinical information and apply the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care • Communicate with providers and other parties to facilitate care/treatment • Identify members for referral opportunities to integrate with other products, services and/or programs • Identify opportunities to promote quality effectiveness of Healthcare Services and benefit utilization • Consult and lend expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function • Typical office working environment with productivity and quality expectations Requirements: • 2+ years of experience as a Registered Nurse in adult acute care/critical care setting • Must have active current and unrestricted RN licensure in state of residence • Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours • 2+ years of clinical experience required in med surg or specialty area (preferred) • Managed Care experience preferred, especially Utilization Management (preferred) • Associates Degree required, BSN preferred Benefits: • Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for all colleagues including 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 Apply tot his job Apply To this Job