Utilization Management Nurse Consultant – Weekends, 4-10 Hour Shifts

Job Description:• Utilizes clinical experience and skills in a collaborative process to assess, plan, implement, coordinate, monitor and evaluate options to facilitate appropriate healthcare services/benefits for members. • Gathers clinical information and applies the appropriate clinical criteria/guideline, policy, procedure and clinical judgment to render coverage determination/recommendation along the continuum of care. • Communicates with providers and other parties to facilitate care/treatment.• Identifies members for referral opportunities to integrate with other products, services and/or programs. • Identifies opportunities to promote quality effectiveness of Healthcare Services and benefit utilization. • Consults and lends expertise to other internal and external constituents in the coordination and administration of the utilization/benefit management function. Requirements:• 3+ years of experience as a Registered Nurse• Must have active current and unrestricted RN licensure in state of residence• 1+ years of Med/Surg experience• 1+ years of experience with bolthires Office applications (Outlook, Teams, Excel)• Must be willing and able to work Friday, Saturday, Sunday and Monday 10 hr shifts after approx 4-5 months of training Monday - Friday 8:30-5pm EST with occasional holiday rotation.• Associates degree required• BSN preferredBenefits:• Affordable medical plan options• 401(k) plan (including matching company contributions)• Employee stock purchase plan• No-bolthires programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.Apply tot his job