UM Nurse Reviewer
Blue Cross & Blue Shield of Rhode Island(1 month ago)
About this role
A Registered Nurse position within Blue Cross & Blue Shield of Rhode Island’s utilization management team focused on supporting care quality and member outcomes across the health plan. The role is part of a clinical operations group that contributes to organizational initiatives and supports member engagement and continuity of care. It operates within the insurer’s programs to improve health management and service delivery for Rhode Islanders.
Required Skills
- Utilization Review
- Concurrent Review
- Discharge Planning
- Telephonic Outreach
- Health Assessment
- Care Coordination
- Case Management
- Data Analysis
- Communication
- Negotiation
+5 more
Qualifications
- Active RN License (Nurse Licensure Compact)
- Bachelor’s Degree in Nursing
- Certified Case Management
- Certified Professional Utilization Review (CPUR)
- Valid Driver’s License
About Blue Cross & Blue Shield of Rhode Island
bcbsri.comN/A
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