Utilization Management Nurse - St. Luke's Health Plan - 157742

Description & Requirements At St. Luke’s Health Plan, we’re on a mission to connect people with affordable, hassle-free health care. We are the only health plan in Idaho putting doctors and insurance on the same team to deliver a more efficient and quality health care experience with less stress. Join us in this bold ambitious journey. We’d love to hear from you! St. Luke’s Health Plan is a wholly-owned, not-for-profit subsidiary of St. Luke’s Health System, offering health insurance coverage for individuals, families and employers across south central and southwestern Idaho. Building on more than 120 years of committed service to Idaho, St. Luke’s Health Plan is on a bold and ambitious mission to redefine the coverage to care experience, removing barriers for both members and providers and creating a more seamless, hassle-free experience. What You Can Expect Responsible for reviewing and assessing requests for medical procedures, treatments, services, and inpatient admissions to ensure they meet medical necessity criteriaTimely and accurate review of preauthorization requests, facilitating the best possible care for St. Luke's Health Plan members while managing healthcare costsFully benefitted position with hospital contributionsHybrid Work Schedule-3 days at home, 2 days on siteMonday-Friday 8-4:30One Saturday coverage per year Qualifications Education: Bachelor of Science in Nursing (BSN) or Associates of Nursing DegreeExperience: 3 years relevant experience (BSN) or 5 years relevant experience (ASN)Licenses/Certifications: Current RN licensure in Idaho UM Experience And Medicare Advantage Plan Preferred What's In It For You At St. Luke’s, caring for people in the communities we serve is our mission – and this includes our own SLHS team. We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Personify Health Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals. St. Luke’s is an equal opportunity employer and does not discriminate against any person on the basis of race, religion, color, gender, gender identity, sexual orientation, age, national origin, disability, veteran status, or any other status or condition protected by law. Please note: this posting is not reflective of all job duties and responsibilities and is intended to provide an overview to job seekers.