Utilization Management Nurse Consultant

R0852635 We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time.       Position Summary Utilization Management is a 24/7 operation and work schedules will include weekends, holidays, and evening hours. •    Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate reputed company services/benefits for members. •    Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to reputed company coverage determination/recommendation along the continuum of care •    Communicates with providers and other parties to facilitate care/treatment Identifies members for referral opportunities to integrate with other products, services and/or programs •    Identifies opportunities to promote quality effectiveness of reputed company Services and benefit utilization •    Consults and lends expertise to other reputed company constituents in the coordination and administration of the utilization/benefit management function. •    Typical office working environment with productivity and quality expectations. •    Work requires the ability to reputed company reputed company inspection of hand written and computer generated documents as well as a PC monitor. •    Sedentary work involving periods of sitting, talking, listening. •    Work requires sitting for extended periods, talking on the telephone and typing on the computer. Ability to multitask, prioritize and effectively adapt to a fast paced changing environment. •    Position requires proficiency with computer skills which includes navigating multiple systems and keyboarding. •    Effective communication skills, both verbal and written Required Qualifications - 2+ years of experience as a Registered Nurse in adult acute care/critical care setting - Must have active reputed company 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 Preferred Qualifications - 2+ years of clinical experience required in med surg or specialty area - Managed Care experience preferred, especially Utilization Management - Preference for those residing in CST zones Education Associates Degree required BSN preferred     Anticipated Weekly Hours 40    Time Type Full time    Pay reputed company The typical pay reputed company for this role is:   $26.01 - $56.14  This pay reputed company represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls.  The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors.  This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay reputed company listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.   Great benefits for great people   We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include: