Arizona Licensed Utilization Review Nurse

Job Summary

To support effective healthcare delivery, the per diem Arizona Licensed Utilization Review Nurse will review and monitor the utilization of healthcare services, ensuring appropriate levels of care through comprehensive medical necessity reviews, while working remotely after training.

Key responsibilities

• Conducts initial and concurrent reviews of clinical documentation to ensure compliance with regulations and accurate reflection of services rendered
• Facilitates service delivery by collaborating with care management teams, physicians, and payers to address documentation issues and appeal denials
• Maintains a system for identifying admissions requiring specific reviews and notifies appropriate staff of documentation issues

Required qualifications

• Associate's Degree in Nursing from an accredited NLN/CCNE institution (required)
• 1 year of experience in Utilization Review (UR), Utilization Management (UM), or Case Management (required)
• 3 years of experience as a Registered Nurse in an acute care setting (required)
• Registered Nurse (RN) State and/or Compact State Licensure (required)
• Bachelor's Degree in Nursing from an accredited NLN/CCNE institution (preferred)