Registered Nurse - Utilization Review / CDI

Job Description

Job Summary:
The Utilization Review Nurse specializes in ensuring appropriate patient care through comprehensive review and discharge planning. They collaborate with healthcare teams to optimize discharge processes and ensure documentation compliance.

Responsibilities:

• Evaluate patient admissions and stays to determine appropriate utilization of resources.
• Coordinate discharge planning by initiating ongoing communication with patients and families.
• Conduct daily rounds with bedside staff, physicians, and ancillary teams to review care plans.
• Communicate with physicians to establish discharge timelines and required documentation.
• Complete MDS documentation and assist with obtaining referrals and prior authorizations for ancillary services.
• Run Interqual reviews for each inpatient and observation patient to ensure appropriate level of care.

Qualifications:

• Hold a valid Registered Nurse (RN) license.
• Proven experience in utilization review, care coordination, or discharge planning.
• Strong understanding of Medicare, Medicaid, HMO, and private insurance coverage criteria.
• Excellent communication skills to liaison effectively with patients, families, and healthcare providers.
• Ability to interpret clinical documentation and perform clinical reviews accurately.

Benefits & Growth:

• Access to ongoing education and professional development opportunities.
• Opportunity to work within a collaborative healthcare team focused on quality patient care.

Benefits

• Day 1 Medical, Dental, and Vision insurance
• Travel reimbursement for assignments
• Paid sick leave and additional valuable benefits
• Access to our $1,000 Inspire a Friend Referral Program

Why TactStaff?
Choosing TactStaff means partnering with a team that understands the unique demands and rewards of Utilization Review / CDI . We're here to provide you with meaningful assignments that support your professional growth while ensuring each role is a step toward achieving your long-term career goals.


Apply today to experience how TactStaff can elevate your Utilization Review / CDI career!