Utilization Management Nurse Consultant, NICU, RN
Job Description: • Conduct clinical reviews of NICU requests for medical necessity, appropriateness, and level of care using evidence-based criteria • Collaborate with healthcare providers, case managers, and families to optimize care pathways • Ensure compliance with regulatory and organizational standards • Provide education and support regarding utilization management processes to colleagues and providers • Document clinical determinations and rationales in accordance with policy • Participate in quality improvement initiatives and interdisciplinary meetings as needed Requirements: • Must have active, current and unrestricted RN licensure in TX • 5 years of recent NICU nursing experience • Must be willing and able to work Monday - Friday 8 am - 5 pm CST with occasional weekend/holiday on-call • Position requires proficiency with computer skills which includes navigating multiple systems • Ability to work in a fast paced environment Benefits: • Affordable medical plan options • 401(k) plan (including matching company contributions) • Employee stock purchase plan • No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. • Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility. Apply tot his job