More jobs:
RN Utilization Management: Clinical Review & Cost Care
Job in
Boise, Ada County, Idaho, 83701, USA
Listed on 2026-07-14
Listing for:
Arkansas Blue Cross and Blue Shield
Full Time
position Listed on 2026-07-14
Job specializations:
-
Nursing
Healthcare Nursing, RN Nurse, Clinical Nurse Specialist
Job Description & How to Apply Below
Arkansas Blue Cross and Blue Shield seeks an Utilization Management Nurse to review prior approvals, network exceptions, benefit inquiries, and inpatient/outpatient services for medical necessity. The role evaluates care against evidence-based criteria and corporate guidelines to promote quality and cost containment.
The ideal candidate has a nursing degree, an active RN license, and at least four years of clinical practice with utilization management experience preferred.
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