Top 9 Utilization management nurse Jobs in Columbus, Ms

Referral Management Licensed Practical Nurse (LPN)
International SOS Government Medical Services —Columbus, MS
- Full-time
- Nursing
- Customer service
- BLS Certification
- Health insurance
- Dental insurance
Quick Apply
12d
Registered Nurse
Optum —Starkville, MS
- $64,132 - $96,198 a year
- Full-time
- CPR Certification
- RN License
- Writing skills
Quick Apply
Dialysis Clinical Manager Registered Nurse - RN
Fresenius Medical Care —Columbus, MS
- Full-time
- Nursing
- RN License
- Administrative experience
- Tuition reimbursement
11d
Utilization Management Reviewer
Amerihealth Caritas —United States
- Full-time
- Hybrid work
- Nursing
- Microsoft Outlook
- RN License
- Paid holidays
- Health insurance

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Referral Management Licensed Practical Nurse (LPN)
International SOS Government Medical Services —Columbus, MS
Current, unrestricted Licensed Practical Nurse (LPN) license in good standing and current BLS certification through the American Heart Association or American…
Quick Apply
12d
Patient Care Specialist (Medical Receptionist)
Fast Pace Health —Columbus, MS
Level 2: High School Diploma or its equivalent with a current CPR license* and 3 years’ experience in billing and coding and intermediate computer skills, which…
5d

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Referral Management Licensed Practical Nurse (LPN)

International SOS Government Medical Services -
Columbus, MS

Quick Apply

Job Details

Full-time
12 days ago

Benefits

Health insurance
Dental insurance
401(k)
Paid time off
Vision insurance
Life insurance

Qualifications

Customer service
BLS Certification
Healthcare referral management
Client referral services
Patient care
LPN
Productivity software

Full Job Description

Company Description

Support specialty care coordination within a military healthcare environment where clinical judgment, referral management, and patient education help ensure beneficiaries receive timely access to appropriate care.

At International SOS Government Medical Services, you'll support healthcare programs that improve patient care and operational readiness across the U.S. and internationally. Founded in 1984, International SOS operates in more than 90 countries, delivering healthcare, medical assistance, emergency response, and workforce support services worldwide.

Job Description

You'll use your clinical nursing experience to coordinate specialty care referrals that help military beneficiaries access timely, appropriate healthcare services. Working within a Referral Management Center (RMC), you'll review referrals, educate patients, collaborate with providers, and help ensure referrals move efficiently from initiation through completion while supporting continuity of care.

Schedule: Full-Time | Monday-Friday | Days (7:30 AM-4:30 PM) | Federal Holidays & Scheduled Down Days Off

Key Responsibilities

Review, coordinate, and manage specialty care referrals from initiation through completion while ensuring compliance with TRICARE requirements, referral management business rules, and established timeliness standards.
Assess referral completeness, verify patient eligibility and demographic information, coordinate with referring providers when additional clinical information is needed, and schedule specialty appointments within established access-to-care guidelines.
Educate patients regarding referral processes, specialty appointments, required testing, procedures, and pre-appointment instructions while serving as a clinical resource for referral-related questions.
Collaborate with providers, case managers, utilization management staff, specialty clinics, and network partners to facilitate appropriate referrals, resolve referral issues, and support continuity of care.
Monitor referral activity, obtain and process specialty care documentation, maintain accurate referral records, generate referral-related reports, and help ensure referral documentation is returned to the patient's medical record within established timelines.
Perform first-level clinical reviews of specialty referrals, identify patients who may benefit from additional care coordination, participate in quality improvement activities, and contribute to ongoing Referral Management Center operations.

Qualifications

Requirements

Graduate of an accredited practical or vocational nursing program.
Current, unrestricted Licensed Practical Nurse (LPN) license in good standing and current BLS certification through the American Heart Association or American Red Cross.
2+ years of broad-based clinical nursing experience in an inpatient or outpatient setting within the last three (3) years.
Experience interpreting and applying medical necessity criteria or utilization review guidelines, such as InterQual or Milliman Ambulatory Care Guidelines.
Working knowledge of referral management processes, electronic medical systems, Microsoft Office applications, customer service principles, and professional healthcare communication.

Preferred

Experience supporting referral management, utilization management, case management, or care coordination within a military, government-supported, or integrated healthcare environment.
Experience working with TRICARE, CHCS, AHLTA, HAIMS, RMS, DEERS, or similar healthcare information systems.

Additional Information

ll your information will be kept confidential according to EEO guidelines.

Privacy Disclaimer: Policy Link

By clicking “I’m Interested” and submitting your application, you acknowledge that you have read and understood the applicable Privacy Policy (available via the link above) and agree that International SOS Government Medical Services, may collect, use, store, transfer, and otherwise process your personal information in accordance with that Privacy Policy for recruitment and hiring purposes.

Compensation Disclaimer:
Pay range is based on several factors and may vary in addition to a full range of medical, financial, and/or other benefits. Final salary and offer will be determined by the applicant’s background, experience, skills, internal equity, and alignment with geographical market data.

Benefits Language (FTE roles):
Full-time positions are eligible for our comprehensive and competitive benefits package including medical, dental, vision, and basic life insurance. Additional benefits include a 401k plan, paid time off, and an annual bonus. International SOS Government Medical Services complies with all federal, state, and local minimum wage laws.

Equal Opportunity Employer (EEO) Statement:
International SOS Government Medical Services is an equal opportunity employer and does not discriminate against employees or job applicants on the basis of race, color, religion, gender, sexual orientation, gender identity, national origin, age, disability, genetic information, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state, and local laws.

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utilization management nurse jobs in columbus, ms

Referral Management Licensed Practical Nurse (LPN)

Registered Nurse

Dialysis Clinical Manager Registered Nurse - RN

Utilization Management Reviewer

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