RN I/Concurrent Review

This role serves as a Utilization Management Registered Nurse, responsible for assessing patients' clinical needs against established guidelines to ensure appropriate levels of care and length of stay. Candidates will coordinate the delivery of high-quality, cost-effective care across the continuum, negotiate fees for out-of-network services, and advocate for members among various healthcare sites. The position requires a minimum of two years of clinical experience and focuses on managing member outcomes and resource utilization.