Utilization Management Nurse Reviewer

A company is looking for a Utilization Management Nurse Reviewer (RN/LPN). Key Responsibilities Conduct assessments of medical services to validate appropriateness and necessity using established criteria and guidelines Examine patient records to verify quality of care and necessity of services provided Provide clinical expertise and serve as a reference for non-clinical staff Required Qualifications, Training, and Education Licensed Practical/Vocational Nurse or Registered Nurse with an active and unrestricted license Minimum of 2 years clinical nursing experience required At least 1 year of previous experience in Utilization Management required Background in medical or clinical practice through education, training, or professional engagement Proficient with Microsoft tools such as Word, Excel, PowerPoint, and Outlook

May 15, 2025 - 17:36

A company is looking for a Utilization Management Nurse Reviewer (RN/LPN). Key Responsibilities Conduct assessments of medical services to validate appropriateness and necessity using established criteria and guidelines Examine patient records to verify quality of care and necessity of services provided Provide clinical expertise and serve as a reference for non-clinical staff Required Qualifications, Training, and Education Licensed Practical/Vocational Nurse or Registered Nurse with an active and unrestricted license Minimum of 2 years clinical nursing experience required At least 1 year of previous experience in Utilization Management required Background in medical or clinical practice through education, training, or professional engagement Proficient with Microsoft tools such as Word, Excel, PowerPoint, and Outlook