Arizona Licensed Utilization Review RN

Job Summary

To support effective healthcare delivery, the per diem Arizona Licensed Utilization Review RN will conduct medical necessity reviews, facilitate service delivery, and collaborate with healthcare teams while working remotely and committing to at least 8 shifts per month.

Key responsibilities

• Review clinical documentation and ensure compliance with regulations for all patients entering the healthcare continuum
• Coordinate and conduct medical necessity reviews for various payers, collaborating with physicians and case managers to address denials
• Initiate and maintain a system for identifying admissions with specific diagnoses, notifying appropriate staff of documentation issues

Required qualifications

• Associates in Nursing from an accredited NLN/CCNE institution (Required) or Bachelors in Nursing (Preferred)
• 1 year of experience in Utilization Review/Utilization Management or Case Management (Required)
• 3 years of experience as a Registered Nurse in an acute care setting (Required)
• Registered Nurse (RN) license in Arizona or compact state (Required)
• Certified Case Manager certification (Preferred)