Illinois Licensed Utilization Review RN
Job Summary
A company is looking for an RN-Utilization Review (S).
Key Responsibilities
- Evaluates medical necessity and appropriateness of hospital admissions and surgical procedures
- Discusses criteria and payor decisions, escalating denials for peer consideration
- Documents outcomes in electronic medical records and participates in team improvement efforts
Required Qualifications and Education
- Graduate of an accredited school of nursing or equivalent education for licensing
- Two years of registered nurse experience
- Registered Professional Nurse (RN) license in the applicable state of work location
- Must be licensed in Illinois, Missouri, Oklahoma, or Wisconsin as required
COMPLETE JOB DESCRIPTION
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