Ohio Licensed Utilization Nurse
Job Summary
To support healthcare excellence, the full-time Ohio Licensed Utilization Nurse will evaluate medical necessity, collaborate with interdisciplinary teams, and ensure authorization of services while working remotely during day shifts.
Key responsibilities:
- Perform initial and concurrent reviews to determine medical necessity using evidence-based criteria
- Validate appropriate patient classification based on CMS regulations and payer requirements
- Coordinate with the interdisciplinary care team and document any delays in care
Required qualifications:
- Associate's Degree in Nursing; BSN required within 5 years of hire
- 3-4 years of clinical nursing experience
- Current Registered Nurse license upon hire
- Familiarity with Microsoft Outlook, Word, TEAMS, EPIC, and Voalte
- Prior experience in a self-directed position
Complete Job Description
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