Utilization Review Nurse | Up to $63/hr + Pension Benefits
$63 per hourLanceSoft Inc
Job Description
Job Description
Title: Utilization Review Nurse (RN)
Department: Case Management
Job Type: Full-Time
Facility Details
- Academic Medical Center
- Nevada’s:
- Level I Trauma Center
- Verified Burn Center
- Transplant Center
- First & only Magnet®-Recognized hospital in Nevada
- Major tertiary care hospital serving Southern Nevada
Pay & Benefits
- Hourly Pay: $40 – $63/hour
- Employer-paid Nevada PERS pension
- Competitive health & retirement benefits
- No state income tax in Nevada
Position Summary
The Utilization Review Nurse evaluates patient admissions and hospital stays to ensure:
- Medical necessity
- Appropriate level of care
- Efficient resource utilization
- Compliance with insurance/payer requirements
Main duties:
- Review medical records/charts
- Apply InterQual & Milliman criteria
- Coordinate with physicians/case managers
- Ensure accurate documentation
- Support discharge planning and utilization management
- Verify compliance with Medicare/Medicaid guidelines
Requirements
Education
- Graduate of accredited nursing school
Experience
Required:
- 5 years acute-care clinical RN experience
- Minimum 1 year in:
- Utilization Management
- Case Management
- Clinical Documentation Improvement (CDI)
- 3+ years Utilization Management experience
- 3+ years discharge planning experience in acute care
- Experience with:
- InterQual
- Milliman guidelines
Must be able to pass InterQual exam.
License & Certifications
Required:
- Active Nevada RN license
~SK
\nCompany DescriptionLanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.
Company Description
LanceSoft is rated as one of the largest staffing firms in the US by SIA. Our mission is to establish global cross-culture human connections that further the careers of our employees and strengthen the businesses of our clients. We are driven to use the power of our global network to connect businesses with the right people, and people with the right businesses without bias. We provide Global Workforce Solutions with a human touch.
Vacancy posted more than 2 months ago
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