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Sr. Utilization Nurse Consultant (Remote)

Alvarez & Marsal, Inc. • US-Nationwide

Posted 16 days ago

Job Snapshot

Full-Time
Healthcare - Health Services, Consulting, Managed Care
Health Care, Consultant, Nurse
75+

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Job Description


Company Overview:

Alvarez & Marsal is a leading independent global professional services firm, specializing in providing turnaround management, performance improvement and corporate advisory services, is seeking to expand its Healthcare Industry Group practice with an emphasis in clinical management through its newly formed Clinical Support Services business unit. With more than 2,600 professionals based in locations across North America, Europe, Asia, and Latin America, our firm excels in problem solving and value creation.  Drawing on a strong operational heritage and hands-on-approach, our professionals work closely with organizations and stakeholders to help tackle complex business issues and maximize value.

 

Position Description:

In this position you will work remotely. The utilization review nurses responsibilities include, but are not limited to: Care Facilitation, Utilization Management, Case Management and Discharge Planning. Working closely with our Managing Directors to deliver the highest quality professional services to our clients, The utilization review nurse is responsible for

Ensuring proper utilization of health services by assessing the member’s needs and identifying solutions that promote quality and cost effective care.

PLEASE NOTE: This is a remote position. Please DISREGARD the locations stated in the job site 

Utilization Nurse Consultant:

The Utilization Nurse Consultant is responsible for ensuring proper utilization of health services by assessing the member’s needs and identifying solutions that promote quality and cost effective care.  Perform utilization management, utilization review or concurrent review (inpatient care management)

Determine medical appropriateness of inpatient and outpatient services by evaluating medical guidelines, benefit determination and compliance with state mandated regulations based on MCG criteria and other national guidelines.

  • Ability to work remotely and be available for daily huddle calls via conference call and or WebEx sessions

  • Assess member’s needs
  • Identify solutions to problems and non-standard requests
  • Maintain courteous, professional attitude
  • Collaborate with staff, physicians, care/service coordinators, plan Medical Director, members and their families to coordinate and provide the level of care necessary to meet member’s health need




Job Requirements

Required Qualifications:

  • 3 or more years of Utilization Review experience in Managed Care or Hospital Case Management  
  • Proficiency in software applications including, but not limited to, Microsoft Word, Microsoft Excel, Microsoft PowerPoint and Outlook
  • Excellent verbal and written communication skills; ability to speak clearly and convey complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others.
  • Associates degree in Nursing; BSN preferred
  • Med/Surg experience



PLEASE NOTE: This is a remote position. Please DISREGARD the locations stated in the job site 




EEO Statement:       

It is A&M’s policy to provide equal employment opportunity to all employees and applicants for employment without regard to race, sex, sexual orientation, color, creed, religion, national origin, age, disability, marital status, parental status, family medical history or genetic information, political affiliation, military service or any other non-merit based factor in accordance with all applicable laws, directives and regulations of federal, state and city entities.

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