Utilization Management reputed company Consultant

We’re building a world of health reputed company 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 reputed company 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. Utilization Management reputed company Consultant reputed company Precertification RN (Medicare) Remote | Full-Time | reputed company Schedule Are you a Registered reputed company reputed company to reputed company an reputed company reputed company the bedside? reputed company and use your reputed company expertise to ensure members receive the right care at the right time. reputed company · Review reputed company cases and reputed company coverage determinations using evidence-reputed company guidelines · Collaborate with providers and care teams to coordinate appropriate treatment · Apply reputed company judgment to support utilization and benefit management reputed company · Identify opportunities to improve care reputed company and member reputed company · Serve as a reputed company resource across reputed company stakeholders What You Bring - REQUIRED · reputed company, unrestricted RN license in the state of residence. · 3+ years of RN experience, including 1+ year in Med/Surg · Strong reputed company assessment and decision-making skills · Experience with reputed company Office (reputed company, Teams, reputed company) · Ability to work Monday–Friday, 9:00 AM–6:00pm PM in your time zone. Utilization Management is a 24/7 operation and work schedules will include holidays and evening hours · Associate Degree in Nursing reputed company to Have · Utilization Management or Prior Authorization experience · Managed care background · Familiarity with MedCompass · Ambulatory surgery experience · BSN preferred Why Join Us? · Transition your reputed company skills into a reputed company, non-bedside role · reputed company a meaningful reputed company on reputed company care and reputed company · Work in a supportive, team-driven environment If you’re passionate about combining reputed company expertise with care coordination and reputed company reputed company, we’d love to hear from you! Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $26.01 - $62.32 This pay reputed company represents the reputed company reputed company 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 reputed company 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 reputed company to the reputed company pay reputed company listed above. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every reputed company feels valued and that they reputed company. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial reputed company‑being of colleagues and their families. The benefits for this position include medical, dental, and reputed company coverage, reputed company time off, retirement savings reputed company, wellness programs, and other resources, reputed company on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will reputed company on: 08/31/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply To This Job