Registered Nurse - Utilization Review / CDI
TactStaff
Job Description Job Summary:
Seeking an experienced Registered Nurse specializing in utilization review to assess non-acute cases. This role involves evaluating patient records to ensure appropriate care and resource utilization while maintaining compliance with regulatory and organizational standards. Responsibilities:
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!
Seeking an experienced Registered Nurse specializing in utilization review to assess non-acute cases. This role involves evaluating patient records to ensure appropriate care and resource utilization while maintaining compliance with regulatory and organizational standards. Responsibilities:
- Analyze patient records and clinical documentation to determine appropriate utilization of healthcare services.
- Collaborate with multidisciplinary teams to review and approve care plans based on established criteria.
- Document findings and maintain accurate, detailed records to support compliance and reporting.
- Stay current with regulatory standards and best practices related to utilization review and patient care.
- Participate in ongoing training and professional development activities to enhance review skills.
- Assist in continuous quality improvement initiatives related to clinical utilization.
- Possess a valid New York State RN license.
- Have at least 1 year of non-acute utilization review experience.
- Demonstrate proficiency in primary source verification and AHA BLS certification.
- Exhibit strong clinical judgment and attention to detail.
- Communicate effectively with healthcare teams and external reviewers.
- Maintain compliance with all relevant healthcare regulations and organizational policies.
- Access to ongoing professional development opportunities.
- Supportive environment that encourages career advancement within healthcare administration and review.
- 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!
Vacancy posted 4 days ago
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