AZ - Utilization Review RN

Details

Client Name
Tuba City Regional Health Care

Job Type
Travel

Offering
Nursing

Profession
RN

Specialty
Case Manager

Job ID
35522989

Job Title
AZ - Utilization Review RN

Weekly Pay
$2652.28


Shift Details

Shift
Day - 8x5 - 08AM

Scheduled Hours
40


Job Order Details

Start Date
09/07/2026

End Date
12/07/2026

Duration
13 Week(s)


Job Description
Job Title: Utilization Review RN
Profession: Nursing
Specialty: Utilization Review RN
Duration: 13 weeks
Shift: Monday - Friday
Hours per Shift: 8 am - 5 pm
Experience: Minimum of 3 years of clinical nursing experience
License: Current and unrestricted Professional Nursing License in any U.S. state, territory, or Commonwealth
Certifications: Basic Life Support (BLS) certification by the American Heart Association (AHA)


Must-Have:
- Bachelor's Degree in Nursing
- Demonstrated knowledge of case management, referred care, and utilization review processes
- Knowledge of electronic health record systems


Description:
The Utilization Review Nurse ensures that patients receive appropriate care by verifying medical necessity.
They confirm the correct patient status and monitor the ongoing need for services.
The role involves working to reduce unnecessary length of stay and prevent delays.
They support accurate clinical documentation for proper reimbursement.
The nurse coordinates with providers and the care team on discharge planning and transitions.
They manage resource use to control costs and communicate with payers to prevent denials.
Ensuring compliance with regulatory requirements is essential.
Contributions to reporting and quality improvement efforts are also part of the position.
They serve as a key liaison between clinical care, finance, and regulatory requirements.
The role directly impacts patient outcomes, hospital efficiency, and the organization's financial performance.


Client Details

Address
167 Main St

City
Tuba City

State
AZ

Zip Code
86045


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