Utilization Management Nurse

Location
:
Onsite in Dubuque, IA. Also accepting remote applicants.

We are looking for a nurse just like you - a nurse that thrives in a fast‑paced environment, enjoys making a difference for patients, and prefers working in a professional office setting with daytime office hours and weekends/holidays off.

This position is responsible for working telephonically with providers to evaluate and pre‑certify requests such as hospital stays, outpatient surgeries, outpatient tests, and care. Requests are reviewed and matched to evidence‑based guidelines to ensure proper care, that the right service is happening at the right time, and that it is medically necessary. The role involves handling multiple provider calls simultaneously in a very fast‑paced environment.

You will also work closely with participants for referrals to case management and condition management services according to referral criteria and health plan guidelines.

Qualified candidates will have strong multitasking skills, RN and clinical experience, preferably in ER, ICU, mental health, orthopedics, and/or pain management. Bilingual is also preferred.

• Flex Spending or HSA
• 401(k) with company match
• Profit‑Sharing/Defined Contribution (1‑year waiting period)
• PTO/Paid Holidays
• Company‑paid ST and LT Disability
• Maternity Leave/Parental Leave