Job Title: Utilization Management Nurse

Job Description

• Perform a minimum of 25 reviews a day with a 97% QA review.
• Provide consultation and responses to utilization management requests.
• Establish relationships and engage with members and providers through telephonic communication.
• Obtain necessary information and facilitate care in multiple settings.
• Utilize clinical knowledge to interpret and apply medical policy and criteria.
• Complete medical reviews and apply utilization review criteria for patient admissions, various levels of care, continued stay reviews, and discharge planning.
• Document events accurately within the care management platform.

Qualifications

• Registered Nurse (RN) license in Iowa or Compact License if not residing in Iowa or South Dakota.
• Bachelor's degree in Nursing
• 4 years of diverse clinical experience (e.g., critical care, acute care, outpatient) with direct clinical care.
• 2 years of utilization review experience
• Experience in acute care, home health, and medical-surgical settings.
• Strong written and verbal communication skills.
• Technical proficiency with Microsoft Office and clinical documentation platforms.

Pay and Benefits

The pay range for this position is $33.00 - $38.00/hr.

Eligibility requirements apply to some benefits and may depend on your job classification and length of employment. Benefits are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the following:

• Medical, dental & vision
• Critical Illness, Accident, and Hospital
• 401(k) Retirement Plan – Pre-tax and Roth post-tax contributions available
• Life Insurance (Voluntary Life & AD&D for the employee and dependents)
• Short and long-term disability
• Health Spending Account (HSA)
• Transportation benefits
• Employee Assistance Program
• Time Off/Leave (PTO, Vacation or Sick Leave)

Workplace Type

This is a fully remote position.

Application Deadline

This position is anticipated to close on Feb 21, 2025.

About Actalent

Actalent is a global leader in engineering and sciences services and talent solutions. We help visionary companies advance their engineering and science initiatives through access to specialized experts who drive scale, innovation and speed to market. With a network of almost 30,000 consultants and more than 4,500 clients across the U.S., Canada, Asia and Europe, Actalent serves many of the Fortune 500.

Diversity, Equity & Inclusion

At Actalent, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through:

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.

If you would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability, please email actalentaccommodation@actalentservices.com for other accommodation options.

Salary : $33 - $38