Utilization Review Nurse Job at Innovative Systems Group, Albuquerque, NM

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  • Innovative Systems Group
  • Albuquerque, NM

Job Description

Job Title: UMCM Coordinator

Location: Alb NM - Remote and occasional onsite meetings

Pay rate: 40.00/hr on W2

Duration: July 2025 to July 2026 (possible extension)

Description:

This position is responsible for performing concurrent review in accordance with accepted department criteria; performing discharge planning and identifying alternate treatment programs; conducting episodic case management, consulting and collaborating with providers, members, and other resources as appropriate; assessing, planning, and implementing options and services require to meet an individuals health needs within the scope of their benefit plan.

JOB REQUIREMENTS:

- Register Nurse (RN) with current, valid, unrestricted license in state of operations or reciprocity.

- 3 years of clinical experience

- Experience utilizing various software packages.

- Verbal and written communication skills

- Analytical skills

PREFERRED JOB REQUIREMENTS:

- Familiarity with UM/CM activities and standardized criteria set.

- Knowledge of ancillary services including HHC, SNF, Hospice, etc.

*Training is completed through Microsoft Teams precepting. Worker should be able to hit the ground running.

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