Arizona Licensed Utilization Review Nurse
Job Summary
To ensure healthcare efficiency and quality, the remote Arizona Licensed Utilization Review Nurse will conduct meticulous reviews of medical records, authorize services, and collaborate with healthcare teams to monitor patient care for appropriateness and cost-effectiveness.
Key responsibilities
- Conduct admission and continued stay reviews to determine the appropriateness of hospitalization based on established criteria
- Ensure compliance with utilization review principles, hospital policies, and external regulatory agencies
- Communicate timely with physicians, payers, and Care Coordinators regarding review outcomes and patient status
Required qualifications
- Graduate of an accredited school of nursing
- Minimum two (2) years of acute hospital clinical experience or a Master's degree in Case Management or Nursing in lieu of one year of experience
- Current RN license in Arizona or Compact License
- Ability to pass annual Inter-rater reliability test for Utilization Review products
COMPLETE JOB DESCRIPTION
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