Ohio Licensed Utilization Nurse
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Job Summary
To enhance healthcare delivery, the full-time Ohio Licensed Utilization Nurse will evaluate medical necessity, collaborate with healthcare teams, and manage service authorizations in a remote setting.
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 interdisciplinary care teams to ensure timely authorization of services
Required qualifications:
- Associate's Degree in Nursing required; BSN must be obtained within 5 years of hire
- 3-4 years of clinical nursing experience required
- Current Registered Nurse license upon hire
- Familiarity with Microsoft Outlook, Word, TEAMS, EPIC, and Voalte
- Membership in a related professional organization preferred
Complete Job Description
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