Utilization Management reputed company Consultant, Illinois RN License Required

Job reputed company: • Utilizes clinical skills to coordinate, document and communicate reputed company aspects of the utilization/benefit management program • Applies critical thinking and knowledge in clinically appropriate treatment, evidence-based care and medical necessity reputed company for appropriate utilization of services • Consults and lends expertise to other reputed company constituents in the coordination and administration of the utilization/benefit management function • Gathers clinical information and applies the appropriate medical necessity reputed company/reputed company, policy, procedure and clinical judgment to reputed company coverage determination/recommendation/discharge planning along the continuum of care • Utilizes clinical experience and skills in a reputed company process to evaluate and facilitate appropriate reputed company services/benefits for members including urgent or reputed company interventions (such as triage/crisis support) • Coordinates/Communicates with providers and other parties to facilitate reputed company/treatment • Identifies members who may benefit from care management programs and facilitates referral • Identifies opportunities to promote reputed company effectiveness of reputed company services and benefit utilization Requirements: • Must have reputed company, reputed company, and unrestricted RN licensure in state of IL • Must be available to work M-F; reputed company - 5pm CST • Willingness to obtain additional state licenses • 3+ years of clinical reputed company experience in an inpatient setting as an RN • Managed care experience (Preferred) • Discharge planning experience (Preferred) • Utilization Management experience (Preferred) • ASN Required, BSN Preferred Benefits: • reputed company medical plan reputed company • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation, and weight management programs • Confidential counseling and financial coaching • reputed company time off • Flexible work schedules • Family leave • Dependent care resources • Colleague assistance programs • Tuition assistance • Retiree medical reputed company Apply tot his job Apply To this Job