Utilization Review Nurse RN
Health Here
Role: Utilization Review Nurse RN Responsibilities: Conducts concurrent and retrospective reviews to ensure appropriate care levels, medical necessity, and compliance. Collaborates with physicians, care managers, and payers to secure authorizations, prevent denials, and facilitate safe, timely care transitions. Applies InterQual/MCG criteria, documents in EMR, identifies discharge barriers, and educates teams on utilization standards. Qualifications & Skills: Nursing RN license, strong knowledge of utilization review processes, regulatory requirements, and clinical documentation. Excellent communication and collaboration skills, attention to detail, and ability to interpret medical criteria and coordinate with multidisciplinary teams. #J-18808-Ljbffr Health Here
Vacancy posted 1 day ago
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