Utilization Review RN

Job Summary

A company is looking for a Utilization Review RN, Part-Time.

Key Responsibilities

• Review and evaluate electronic medical records for emergency admissions and assess medical necessity using InterQual or MCG criteria
• Participate in discussions with emergency department physicians regarding documentation and admission status
• Analyze utilization patterns and trends to identify problems or inappropriate resource use

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 in acute admission and concurrent reviews
• Intermediate experience with InterQual and/or MCG criteria within the last two years
• Proficiency in electronic medical record review and Microsoft Suite