State Licensed Utilization Review Nurse

A company is looking for a Utilization Review Nurse.

Key Responsibilities

Review and evaluate electronic medical records for emergency department admissions and screen for medical necessity

Apply evidence-based clinical guidelines to assess healthcare resource utilization

Participate in discussions with emergency department physicians regarding documentation and admission status

Required Qualifications

Current and unrestricted RN license

At least 3 years of clinical experience in an acute care setting

At least 2 years of utilization management experience in acute admission and concurrent reviews

Intermediate experience with InterQual and / or MCG criteria within the last two years

Proficiency in electronic medical record (EMR) review