Utilization Management RN, CHOC Health Alliance

CHOC • Charlotte, NC

6d • $110,094 - $181,626 • Onsite

About The Position

The Utilization Management (UM) RN utilizes independent clinical judgement and expertise to coordinate benefit management, and promote quality, cost- effective health care. The UM RN works both independently, while also collaborating with the Medical Director and entire UM team, to ensure requests are reviewed with consideration to medical necessity, appropriateness of requested services and compliance with regulatory guidelines. This position requires attention to detail, outstanding organizational skills and efficient work habits.

Requirements

• Minimum of two (2) years of pediatric experience
• Bachelor of Science in Nursing degree (BSN)
• Able to communicate effectively in English in person, in writing, and on the telephone
• Think critically
• Manage multiple assignments effectively
• Organize and prioritize workload
• Work well under pressure
• Problem solve
• Recall information with accuracy
• Pay close attention to detail
• Work independently with minimal supervision
• California Registered Nurse license

Nice To Haves

• One or more years of Utilization or Case Management experience
• Experience with Cerner, MCG or other evidence-based clinical guidelines
• EZ-Cap and/or Microsoft Office
• Basic Life Support (BLS) certification

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level