Utilization Management Nurse - Remote

Overview

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 services coordination.
• Requires interpretation and independent determination of appropriate actions.
• Coordinates with providers and members for optimal care.
• Requires a Registered Nurse (RN) license in Florida.
• Minimum of 2 years clinical experience in acute care.
• Excellent computer skills and Microsoft Office proficiency required.
• Work hours are Monday to Friday, 8 am to 5 pm EST.
• Remote position with minimal travel required.
• Background clearance and fingerprinting required.
• Eligible for a bonus incentive plan.

Requirements

• Registered Nurse (RN) in Florida with no disciplinary action.
• 2 years of clinical experience in hospital acute care.
• Proficiency in Microsoft Office products.
• Ability to provide high-speed internet for home office.
• Dedicated workspace to protect member PHI/HIPAA information.
• Utilization management experience preferred.
• Bilingual candidates are a plus.
• Completion of Level II AHCA background clearance.
• Call center or triage experience preferred.
• Medicare/Medicaid experience is a plus.

Benefits

• Medical, dental, and vision benefits.
• 401(k) retirement savings plan.
• Paid time off and holidays.
• Short-term and long-term disability benefits.
• Life insurance options.
• Additional wellness support and resources.
• Paid parental and caregiver leave.
• Volunteer time off.
• Competitive benefits for personal wellness.
• Incentive opportunities based on performance.