Iowa Licensed Utilization Review RN

Job Summary

A company is looking for a Utilization Review RN.

Key Responsibilities

• Provide timely prior approval and post-service reviews for medical necessity and discharge planning
• Collaborate with healthcare providers to gather medical information and facilitate care transitions
• Document review processes and decisions accurately while complying with regulatory and internal standards

Required Qualifications

• Completion of an accredited registered nursing or licensed practical nursing program
• Active and unrestricted RN or LPN license in the state of residence; RN candidates preferred
• 4+ years of diverse clinical experience, preferably in acute care, home health, or medical-surgical settings
• Strong technical acumen and ability to learn new systems quickly
• Knowledge of diagnosis and procedure coding systems such as ICD-10, HCPCS, and CPT