North Carolina Licensed Utilization Review Nurse

Job Summary

To support patient care coordination, the part-time North Carolina Licensed Utilization Review Nurse will manage clinical assessments, perform admission and concurrent reviews, and collaborate with multidisciplinary teams while working remotely during daytime hours from Monday to Wednesday.

Key responsibilities

• Identifies clinical, financial, and psychosocial needs of patients and develops individualized care plans
• Performs admission and concurrent reviews, ensuring compliance with clinical guidelines and managing potential third-party denials
• Collaborates with physicians and the multidisciplinary team to implement and document medical plans of care

Required qualifications

• Graduation from an accredited School of Nursing; Bachelor's degree in nursing preferred
• Current North Carolina RN licensure
• Basic Life Support (BLS) certification for Healthcare Providers
• Prior experience in Utilization Management and Behavioral Health preferred
• Ability to document accurately in medical records according to departmental standards