Utilization Review Nurse
$40 - $63 per hourAccess Healthcare Staffing & Recruitment
Utilization Review Nurse (RN) Las Vegas, NV | Full-Time Salary: $40 – $63/hour Position Summary Reviews patient admissions for medical necessity, appropriate resource utilization, and compliance with payer guidelines. Analyzes medical records to ensure care meets established clinical and regulatory standards. Requirements Education/Experience Graduate of an accredited nursing program 5+ years of acute care nursing experience At least 1 year in Utilization Management, Case Management, or CDI Minimum 3 years of Utilization Management experience 3+ years of discharge planning experience in acute care Licensure Active Nevada RN license Additional Requirements Experience with InterQual (must be able to pass exam) Experience with Milliman criteria Key Skills & Knowledge Utilization review criteria (InterQual/Milliman), Medicare/Medicaid guidelines Chart review and clinical documentation analysis Regulatory compliance and hospital standards Strong communication, collaboration, and analytical skills Work Environment Office-based with extended sitting and computer use May require shifts and weekends #J-18808-Ljbffr
Vacancy posted 13 hours ago
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