Utilization Management Nurse - North Charleston, SC

Select Health, a managed care organization licensed by the South Carolina Department of Insurance, has been serving families in South Carolina since 1996. Our health plan, First Choice, offers enhanced benefits and quality accessible care through collaboration with providers.

We are looking for a Utilization Management Nurse to join our growing Medical Services team. You will be responsible for conducting timely reviews of requests for services required to meet medical necessity criteria, to include reviewing pre-certification for outpatient and inpatient services. You will apply criteria to inpatient admissions and perform concurrent review functions, identifying discharge planning needs and referring members to needed support services, such as case management and disease management.

Requirements include:

  * Must possess a minimum of an Associate's RN degree; Bachelor's degree preferred
  * Must have a minimum of two years experience in quality assurance or utilization review and a minimum of two years of clinical experience in an acute care hospital
  * Must possess a current, unrestricted, active SC nursing license

To Apply: E-mail your cover letter with salary requirements and your resume to michelle.powell@selecthealthofsc.com, Fax to 843-569-8787 or Mail to PO Box 40849, N. Charleston, SC 29423-0849. EOE.