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Nurse for Utilization Management
2 months ago
We are seeking a dedicated **Utilization Management Nurse** to play a vital role in ensuring that our members receive necessary healthcare services in a timely and effective manner. At Cambia Health Solutions, we prioritize delivering personalized and sustainable healthcare solutions that positively impact lives.
Key Responsibilities:- Perform utilization management assessments to evaluate medical necessity and adherence to guidelines.
- Work collaboratively with multidisciplinary teams and external stakeholders to support care transitions.
- Act as a knowledgeable resource for both internal and external parties, providing accurate and timely information.
- Engage in quality enhancement initiatives by pinpointing areas for improvement.
- Associate or Bachelor's Degree in Nursing or a related discipline.
- A minimum of 3 years of experience in case management, utilization management, or similar fields.
- Current licensure in a health or human services profession.
- Excellent communication and organizational abilities.
Cambia Health Solutions is committed to simplifying healthcare and enhancing lives. We strive to foster a healthier future for everyone.
