State Licensed Utilization Review Nurse
Job Summary
To support healthcare resource management, the part-time State Licensed Utilization Review Nurse will evaluate electronic medical records for emergency department admissions, apply clinical guidelines for medical necessity, and engage in discussions with physicians, all while working remotely.
Key responsibilities
- Review and evaluate electronic medical records using InterQual or MCG criteria
- Participate in telephonic discussions with emergency department physicians regarding documentation and admission status
- Analyze utilization patterns and trends to identify issues in resource utilization
Required qualifications
- Current and unrestricted RN license
- At least 3 years of clinical experience in an acute care setting
- Minimum of 2 years of utilization management experience
- Intermediate experience with InterQual and/or MCG criteria
- Proficiency in electronic medical record review and Microsoft Suite
Complete Job Description
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