Kansas Licensed Utilization Nurse Consultant

To support a 24/7 Utilization Management operation, the full-time Kansas Licensed Utilization Nurse Consultant will assess, plan, implement, and evaluate healthcare services for members while working remotely and managing communication with providers and other parties. Key responsibilities Utilizes clinical expertise to assess and facilitate appropriate healthcare services and benefits for members Gathers clinical information and applies criteria to render coverage determinations along the continuum of care Identifies opportunities for quality improvement in healthcare services and collaborates with internal and external stakeholders Required qualifications 2+ years of experience as a Registered Nurse in an adult acute care or critical care setting Active, current, and unrestricted RN licensure in the state of residence Associates Degree in nursing required; BSN preferred Availability to work weekends, holidays, and evening hours as part of a 24/7 operation