Utilization Review RN

Job Title: Utilization Review RN

Are you an experienced Registered Nurse with Utilization Review experience professional looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!

Position Summary:

As the Utilization Review RN, you would be responsible for telephonically reviewing medical information in order to determine medical necessity of continued stay according to review standards. 

Hours for this Position: Monday-Friday 8:00am-5:00pm

Advantages of this Opportunity:

• Competitive salary, negotiable based on experience

• Benefits offered, Medical, Dental, and Vision

• Fun and positive work environment

• Weekly deposit options

More Insight of Daily Responsibilities: 

• Ensures that services provided to eligible members are within benefit plan and appropriate contracted providers are being utilized

• Determines medical necessity and length of stay based on the consistent application of CMS criteria

• Assesses and coordinates simple discharge planning

• Identifies quality of care issues