Utilization Management Nurse
Nebraska(1 month ago)
About this role
As a member of Blue Cross and Blue Shield of Nebraska, this remote nursing position focuses on ensuring high-quality, medically necessary care for members in collaboration with healthcare providers and team members. The role involves conducting clinical claim certification and authorization reviews, educating providers about member benefits, and facilitating transitions of care to promote positive member outcomes.
Required Skills
- Clinical Claim Reviews
- Care Management
- Utilization Management
- Discharge Planning
- Collaboration
Qualifications
- Associate's Degree in Nursing
- Registered Nurse License
- Three Years Clinical Experience
- Experience in Medicare Advantage
- Experience in Discharge Planning
About Nebraska
nebraskablue.comBlue Cross & Blue Shield of Nebraska offers a variety of health, dental & travel insurance plans for groups, individuals and families at an affordable rate.
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