Missouri Licensed Utilization Review RN
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Job Summary
Collaborating with physicians and multidisciplinary teams, the full-time Missouri Licensed Utilization Review RN will facilitate patient care progression, conduct medical record reviews for necessity and appropriateness of services, and serve as a resource for physicians, all while working remotely.
Key responsibilities
- Monitor patient progress and ensure care plans are high quality and cost-effective
- Conduct concurrent medical record reviews to determine the appropriateness of inpatient or observation services
- Educate physicians on resource utilization and national/local coverage determinations
Required qualifications
- Graduate of an accredited school of nursing
- Minimum of 3 years of hospital experience
- Current RN License active in the state of Missouri
- Knowledge of InterQual Level of Care Criteria and/or Milliman Care Guidelines preferred
- Certification as a Case Manager preferred
Complete Job Description
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