Nurse Consultant Utilization Review

Gallagher • Franklin, TN

2d

About The Position

At Gallagher Bassett, we're there when it matters most because helping people through challenging moments is more than just our job, it’s our purpose. Every day, we help clients navigate complexity, support recovery, and deliver outcomes that make a real difference in people’s lives. It takes empathy, precision, and a strong sense of partnership—and that’s exactly what you’ll find here. We’re a team of fast-paced fixers, empathetic experts, and outcomes drivers — people who care deeply about doing the right thing and doing it well. Whether you're managing claims, supporting clients, or improving processes, you’ll play a vital role in helping businesses and individuals move forward with confidence. Here, you’ll be supported by a culture that values teamwork, encourages curiosity, and celebrates the impact of your work. Because when you’re here, you’re part of something bigger. You’re part of a team that shows up, stands together, and leads with purpose.

How you'll make an impact

Provides utilization management review of worker's compensation claims. Accesses medical documentation and information provided by medical providers to determine the appropriateness of treatment, setting and length of treatment required. Communicates with medical providers and ancillary service providers to negotiate or approve treatment. Engages physician review agents as appropriate. Communicates and documents recommendations of treatment to all parties including claims professionals, medical providers, ancillary service providers, employers and employees. Follows national and state guidelines for approval of treatment, medications, etc.

Requirements

• Associate's degree from an accredited school of nursing and a minimum of 3 years acute clinical experience or similar position required.
• Hold an active RN license within the state of practice.
• Willing to be licensed in states requiring same for Utilization Review.
• Demonstrates adequate knowledge of managed care with emphasis on use of criteria, guidelines and national standards of practice.
• Demonstrates good written and oral communications, organizational and leadership skills.
• Computer literate.
• Demonstrates good time management skills.
• Self starter.

Nice To Haves

• Bachelor's degree preferred.
• Prefer experience in worker's compensation or utilization review.

Responsibilities

• Provides utilization management review of worker's compensation claims.
• Accesses medical documentation and information provided by medical providers to determine the appropriateness of treatment, setting and length of treatment required.
• Communicates with medical providers and ancillary service providers to negotiate or approve treatment.
• Engages physician review agents as appropriate.
• Communicates and documents recommendations of treatment to all parties including claims professionals, medical providers, ancillary service providers, employers and employees.
• Follows national and state guidelines for approval of treatment, medications, etc.

Benefits

• Medical/dental/vision plans, which start from day one!
• Life and accident insurance
• 401(K) and Roth options
• Tax-advantaged accounts (HSA, FSA)
• Educational expense reimbursement
• Paid parental leave
• Digital mental health services (Talkspace)
• Flexible work hours (availability varies by office and job function)
• Training programs
• Gallagher Thrive program – elevating your health through challenges, workshops and digital fitness programs for your overall wellbeing
• Charitable matching gift program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree
• Number of Employees: 5,001-10,000 employees