Job Details
Registered Nurse – Utilization Review
We are seeking a skilled Registered Nurse – Utilization Review to review patient care and medical records, support appropriate utilization of healthcare services, and ensure care meets established clinical criteria.
Key Responsibilities:
Review medical records and clinical documentation to determine medical necessity and level of care.
Evaluate admissions, continued stays, and treatment plans using established clinical criteria.
Collaborate with physicians, nurses, case managers, and healthcare teams regarding patient care.
Identify opportunities for appropriate resource utilization and timely interventions.
Communicate with payers and healthcare providers regarding authorization and utilization decisions.
Maintain accurate documentation and ensure compliance with applicable policies and standards.
Qualifications:
Graduate of an accredited nursing program.
Current RN license in the applicable state.
Current BLS certification.
Previous utilization review, case management, clinical, or acute-care nursing experience preferred.
Strong clinical assessment, analytical, communication, and documentation skills.
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.
For more relevant healthcare job opportunities, please visit our website: MedCadre Careers
