Job Details
Utilization Review Registered Nurse (UR RN)
We are seeking a detail-oriented Utilization Review Registered Nurse to evaluate the medical necessity and appropriateness of healthcare services while ensuring quality patient care and regulatory compliance.
Responsibilities:
- Review medical records for medical necessity and appropriate level of care.
- Evaluate admissions, continued stays, and discharge plans.
- Coordinate with physicians, case managers, and insurance providers for authorizations.
- Ensure compliance with clinical guidelines, payer requirements, and regulatory standards.
- Identify opportunities for cost-effective care and resource utilization.
- Maintain accurate documentation of utilization review activities.
Qualifications:
- Active and unrestricted Registered Nurse (RN) license.
- Graduation from an accredited nursing program.
- BLS certification required.
- Strong knowledge of utilization review, case management, and healthcare regulations.
- Excellent analytical, communication, and organizational skills.
- Previous Utilization Review, Case Management, or Acute Care nursing experience preferred.
Pay Rate
$64.28 - $69.16/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
