State Licensed Utilization Review Nurse
Job Summary
A company is looking for a Utilization Review Nurse.
Key Responsibilities
- Perform medical necessity reviews including inpatient, concurrent, and retrospective reviews
- Consult with Medical Directors regarding cases that do not meet applicable criteria
- Document clinical information accurately and maintain compliance with accreditation and regulatory requirements
Required Qualifications
- Bachelor's degree or 4 years of relevant work experience
- Current State licensure as a registered nurse or behavioral health clinician
- 3 years of clinical experience
- CPHM certification or ability to obtain within 36 months of hire
- Utilization Management experience preferred
COMPLETE JOB DESCRIPTION
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