Job Overview:
We are seeking a skilled and experienced Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will be responsible for reviewing medical records and ensuring that patients receive appropriate and cost-effective care. Your expertise in medical documentation, discharge planning, and hospital systems will be crucial in this role.
Responsibilities:
- Conduct utilization reviews to assess the medical necessity and appropriateness of healthcare services
- Review medical records to ensure compliance with regulatory standards and guidelines
- Collaborate with healthcare providers to develop and implement effective care plans
- Evaluate patient outcomes and make recommendations for improvement
- Coordinate with insurance companies to obtain authorization for procedures and treatments
- Provide education to patients, families, and healthcare providers on utilization management processes
Requirements:
- Valid nursing license
- Minimum of 2 years of experience as a Utilization Review Nurse or in a similar role
- Strong knowledge of medical documentation, including ICD-9 coding
- Familiarity with hospital systems such as Cerner
- Experience in discharge planning and care coordination
- Excellent communication and interpersonal skills
- Ability to analyze complex medical information and make informed decisions
- Detail-oriented with strong organizational skills
Benefits:
- Competitive salary based on experience
If you are a dedicated Utilization Review Nurse looking for an opportunity to make a difference in patient care, we would love to hear from you. Apply today to join our dynamic team!
Job Type: Contract
Pay: $39.55 - $46.08 per hour
Expected hours: No less than 36 per week
Benefits:
Healthcare setting:
Schedule:
- 10 hour shift
- 12 hour shift
- 8 hour shift
- Day shift
- Night shift
Experience:
- Utilization review: 2 years (Preferred)
- ICD coding: 1 year (Preferred)
License/Certification:
Ability to Commute:
Work Location: In person