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Utilization Management Nurse

  • Location: Durham, 27707
  • Salary: 30.0
  • Job Type:Contract

Posted 11 days ago

Our Healthcare Insurance client is seeking a Utilization Management Nurse to join their team for a contract role!

Our client has over 5,000 employees and is the number 1 health insurer in the state of North Carolina, serving more than 3.89 million customers. Health care is changing, and our client is leading the way by providing innovative solutions that simplify the health care system, improve efficiency and outcomes, and help rein in costs. Our client is a not-for-profit with headquarters in Durham, NC.

Position: Utilization Management Nurse
Term: 5 + Months
Location: Remote, USA - State of NC preferred, but may recruit within the approved states of NC, SC, Georgia, Florida, Maryland, Pennsylvania, Virginia. EST hour

Required Skills 

  • RN licensure, Compact licensure
  • Must have Licensure in one of the following states: NC, SC, GA, FL, MD, PA, VA.
  • RN preferred, LPNs considered
  • Candidates should have clinical experience, working in a hospital or other medical setting

Desired Skills 

  • UM experience highly preferred.

Description/Comment:
The Episodic Care Manager/UM Nurse is responsible for performing prior authorizations for continuity of care and in-network exceptions to assess, facilitate, and coordinate the delivery of care across the Health Care System. The Episodic Care Manager/UM Nurse also acts as a member advocate to promote and coordinate the delivery of quality, cost effective health care services based on medical necessity utilizing medical policy/contractual benefits. In addition, the Episodic Care Manager coordinates with providers and consumers to support the delivery of high quality care across the health care system.

****To be eligible to contract at this client you must be able to pass a drug test and criminal background check.

Candidates will be responsible for following the client's COVID-19 protocols. Please refer to your MATRIX representative for specifics.

About Us

At MATRIX, we expertly match talented professionals with job opportunities to elevate careers. Since 1983, we have placed thousands of professionals at innovative clients across every industry ranging from small startups to Fortune 50 companies. It’s why we’re consistently in the top 25 of all U.S. IT staffing firms and why our consultants rate us well above the industry average, earning us ClearlyRated's Best of Staffing awards year after year. People come to us for a job, and stay with us because of our top-notch consultant care.

MATRIX is and Equal Employment Opportunity employer including disability and veteran and provides reasonable accommodations for all qualified individuals.  Supporting medical or religious documentation will be required where applicable. If you are a qualified individual you may request a reasonable accommodation under the American Disability Act (ADA). If you are a person with a disability needing assistance applying, or at any point in the hiring process, please email us at MATRIX_HR@MatrixRes.com. To ensure a quick response to your request, please use the words “Accommodation request” as the subject line of your email.

For hourly W2 contract roles MATRIX offers a highly competitive benefit package including Medical, Dental, Vision, Life, Disability, HSA, and 401(k) with pre and post-tax options.  Please see MatrixRes.com/Benefits for more information.

For direct hire placement with our clients, benefits would be offered in accordance with that particular client’s offerings. This may include PTO, Medical, Dental, Vision, 401K and other pre and post-tax options.