RN Utilization Review Nurse
Job Summary
To support a growing behavioral health practice, the full-time RN Utilization Review Nurse will obtain authorizations, conduct concurrent reviews, and collaborate with clinical teams regarding patient care criteria.
Key responsibilities
- Obtain initial behavioral health authorization and complete concurrent reviews
- Review the need for denial of stay with the clinical treatment team when patients no longer meet acute care criteria
- Maintain knowledge of contract requirements for third-party payors and track patient treatment courses
Required qualifications
- Current RN licensure with the State Board of Nursing
- Minimum of 1 year of utilization review experience
- Knowledge of UR Standards of Excellence
- Education from an accredited school of nursing
- Proficiency in Microsoft Office products, including Word and Outlook
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