Utilization Management Nurse 8/16/2016

Confidential Company Newark, DE

Company
Confidential Company
Job Classification
Full Time
Company Ref #
28778720
AJE Ref #
575898388
Location
Newark, DE
Job Type
Regular

JOB DESCRIPTION

APPLY
Judge Healthcare is currently seeking a UTILIZATION MANAGEMENT RN for a large healthcare organization within the Newark, DE area!

THIS JOB WILL HAVE THE FOLLOWING RESPONSIBILITIES:

* Review of appropriateness of health care services
* Application of criteria to assure appropriate resource utilization
* Identification of opportunities for referral to a Health Coach/case management

QUALIFICATIONS & REQUIREMENTS:

* Current DE/Compact RN license and/or additional states as required
* 2-5 years' experience in clinical setting
* Utilization Management experience
* Proficient InterQual experience
* Two (2) years of any combination of clinical, case management and/or disease/condition management, provider operations and/or health insurance experience

* Two (2) years of any combination of clinical, case management and/or disease/condition management, provider operations and/or health insurance experience