Utilization Review Nurse

Posted 2025-03-15
Remote, USA Full-time Immediate Start

We are looking for a highly motivated and experienced Utilization Review Nurse to join our team at BlueCross BlueShield of South Carolina. As an integral part of our team, the Utilization Review Nurse will be responsible for providing comprehensive care and services to members of our organization. The successful candidate will have a keen eye for detail and a passion for providing exceptional care.The ideal candidate for this position will have a current nursing license in the state of South Carolina and at least two years of direct healthcare experience. They will also possess strong communication skills, with the ability to effectively collaborate with other healthcare professionals. A professional and compassionate demeanor is essential for this role, as is the ability to remain organized in a fast-paced environment. The successful candidate will also have a strong knowledge of evidence based nursing practices and utilization review processes.If you are looking for a dynamic and rewarding opportunity to make a difference in the lives of our members, we would love to hear from you.

Responsibilities: Provide comprehensive care and services to members of BlueCross BlueShield of South Carolina. Ensure that all utilization review processes are carried out in accordance with evidence-based nursing practices. Maintain professional and compassionate demeanor when interacting with members and other healthcare professionals. Monitor and assess members? needs and provide appropriate interventions. Collaborate effectively with other healthcare professionals to ensure the best outcomes for members. Remain organized and attentive to detail in a fast-paced environment. Keep up to date with the latest healthcare trends and regulations. Document care processes and services accurately and in a timely manner. Adhere to all laws and regulations governing healthcare practices and utilization review processes.

BlueCross BlueShield of South Carolina is an Equal Opportunity Employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. We do not discriminate based upon race, religion, color, national origin, sex, sexual orientation, gender identity, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

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