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RN Utilization Review Specialist

4 days ago

PayCompetitive
LocationRemote
Employment typeFull-Time

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  • Job Description

      Req#: 39702
      Overview

      Qualifications

      Minimum Qualifications:

      Associate Degree in Nursing

      2 of the most recent 4 years' working in an acute care setting

      Proficient in word processing and PC based spreadsheet programs

      Licensure, Registration, Certification:

      One of the following:
      • Current Alabama RN license
      • Current Multi State RN License in accordance with Nurse Licensure Compact (NLC) for Alabama*

      *Infirmary Health abides by the NLC requirements and guidelines for the state of Alabama

      For specific areas CRRN (Certified Rehabilitation RN) is required (or eligibility)

      Desired Qualifications:

      BSN

      Some background in management, clinical education or case management

      Desired Licensure, Registration, Certification:

      National certification applicable to area of clinical practice

      Responsibilities

      Improves overall quality and completeness of clinical documentation by performing concurrent review of the medical record to ensure medical necessity and appropriateness of hospital admissions. Provides education to physicians and others to improve the capture of clinical severity for the level of service rendered. Identifies process improvement opportunities and supports the timely and accurate capture of measurements to improve patient outcomes.
  • About the company

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