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State Licensed Utilization Review RN
Job Summary
A company is looking for a Utilization Review RN.
Key Responsibilities:
- Perform initial, concurrent, and/or post-service review activities, discharge care coordination, and assist with efficiency and quality assurance of medical necessity reviews
- Serve as a liaison between providers/facilities
- Adhere to utilization management productivity metrics, quality standards, and documentation requirements
Required Qualifications:
- Graduate of an accredited school of nursing with a current RN license
- Minimum of 3 years clinical experience and 2 years Utilization Management experience
- Experience with clinical denials
- Ability to make independent decisions and problem solve
- Familiarity with medical records assembly and clinical terminology
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COMPLETE JOB DESCRIPTION
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