RN - Utilization Management

Job description

Job Description Spectrum Healthcare Resources has a potential need for Registered Nurse Utilization Managers (RNUM) . These will be completely remote positions, working entirely from the Nurse’s home. The Nurse will be reviewing cases, educating patients on appropriate care and managing health care costs for the dependents of our Nation’s Active Duty and eligible retirees. The Nurse will be working remotely Monday through Friday, 8 hours per day. Requirements: - Bachelors Nursing Degree - At least one active state nurse license, preferably compact state licensure - At least 2 years’ experience working as an RNUM, preferably in a remote or hybrid environment. - Possess current certification in either - Completion of an accredited Certified Professional Utilization Review (CPUR) program - Certified Case Manager (CCM) issued by the Commission for Case Manager Certification. --OR--: - Possess two (2) years of full-time broad based registered nurse experience in a utilization management review or a case management setting within the preceding five (5) years. Notwithstanding the aforementioned experience requirements, the HCWs must have pertinent clinical experience within the past two (...