Job Details
Registered Nurse – Utilization Review
We are seeking a detail-oriented and experienced Registered Nurse to perform utilization review activities and ensure appropriate, cost-effective patient care. The Utilization Review RN will evaluate medical records, assess the necessity of services, and collaborate with healthcare teams to promote quality outcomes and regulatory compliance.
Responsibilities:
• Review patient records to assess medical necessity and appropriateness of care.
• Evaluate admissions, continued stays, and discharge plans.
• Collaborate with healthcare providers to ensure efficient use of healthcare resources.
• Communicate with interdisciplinary teams regarding patient care and authorization needs.
• Ensure compliance with established clinical guidelines and regulatory standards.
• Maintain accurate and timely documentation of utilization review activities.
Qualifications:
• Active and unrestricted Registered Nurse (RN) license.
• Graduation from an accredited nursing program.
• Strong knowledge of utilization review, case management, and healthcare regulations.
• Excellent analytical, communication, and organizational skills.
• Ability to review and interpret clinical documentation effectively.
• Previous utilization review, case management, or acute care experience preferred.
Pay Rate
$48.65 - $53.53/hour
About us :
At MedCadre , we’re dedicated collaborators, bridging the gap between top-tier professionals and healthcare organizations that prioritize excellence. By fostering transparent communication and leveraging deep industry expertise, we build enduring partnerships rooted in trust.
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