Arizona Licensed Utilization Review Nurse

Job Summary

A company is looking for a Registered Nurse (RN) - Utilization Review.

Key Responsibilities

• Facilitate accurate medical necessity screening and submission for Physician Advisor review
• Secure and document authorization for services from payers and manage concurrent disputes
• Collaborate with payers, physicians, and office staff while maintaining timely documentation

Required Qualifications

• Minimum two years of acute care experience in Utilization Review or related fields
• Graduate of an accredited school of nursing
• Active Registered Nurse license
• Working knowledge of InterQual or Milliman guidelines
• Preferred: Bachelor of Science in Nursing (BSN) and Accredited Case Manager (ACM) certification