Utilization Management Nurse

Most benefits start day 1

Medical, Dental, Vision Insurance

Flex Spending or HSA

401(k) with company match

Profit-Sharing/Defined Contribution (1-year waiting period)

PTO/Paid Holidays

Utilization Management Nurse

This position is responsible for working telephonically with providers to evaluate and pre-certify requests such as hospital stays, outpatient surgeries, outpatient tests, care, etc.

Review requests and match up to an evidence-based guideline to ensure proper care and ensure the right service is happening at the right time and is medically necessary.

You will also work closely with participants for referrals to case management and condition management services according to referral criteria and health plan guidelines.

Flex Spending or HSA

Profit-Sharing/Defined Contribution (1-year waiting period)