Oregon Licensed Utilization Review Nurse

Job Summary

Working part-time, the Oregon Licensed Utilization Review Nurse will conduct utilization reviews to assess medical necessity for hospital admissions and continued stays, communicate with payers for authorization, and collaborate with the multidisciplinary team to improve patient outcomes.

Key responsibilities

• Reviews pre-admissions and conducts utilization reviews using established medical necessity guidelines
• Communicates with payers regarding authorizations and resolves order/classification discrepancies
• Participates in strategic initiatives to reduce readmissions and length of stay while providing education to the multidisciplinary team

Required qualifications

• Three years of Utilization Management/Utilization Review experience required
• Baccalaureate Degree in Nursing (BSN) or Associate Degree in Nursing (ADN) with enrollment in a BSN program within three years of hire
• Current, unencumbered Oregon State Registered Nurse License
• BLS certification from AHA required
• Ability to perform essential functions of the position with or without accommodation