RN Utilization Management Nurse 2 - Remote

Overview

Become a part of our caring community and help us put health first. The Utilization Management Nurse 2 utilizes clinical nursing skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations.

In Short

• Utilizes clinical nursing skills for medical service coordination.
• Interprets policies and procedures for optimal treatment.
• Communicates with providers and members for care facilitation.
• Works independently with minimal direction.
• Requires an active Florida RN license.
• Minimum 2 years clinical experience required.
• 3 years experience in Utilization Management preferred.
• Excellent computer and communication skills necessary.
• Work schedule: Monday - Friday, 8:30am - 5:00pm EST.
• Remote position with occasional travel for training.

Requirements

• Active Florida or Compact Registered Nurse Clinical license.
• 2 years clinical experience in acute care or rehabilitation.
• 3 years in Utilization Management with Medicare/Medicaid.
• Strong communication and critical thinking skills.
• Ability to work independently and in a team.
• Health Plan experience preferred.
• MCG Certification is a plus.
• Bilingual candidates preferred.
• Reliable internet service for remote work.
• Dedicated workspace for confidentiality required.

Benefits

• Competitive medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off and holidays.
• Short-term and long-term disability coverage.
• Life insurance options available.
• Opportunities for personal wellness and healthcare decisions support.
• Bonus incentive plan based on performance.
• Comprehensive benefits for you and your family.
• Equal Opportunity Employer policies in place.
• Commitment to improving quality of life for communities.