Travel Registered Nurse (RN) - Utilization Review (UR) - $2,428 per week in Camden, ME

TravelNurseSource is working with Magnet Medical to find a qualified Utilization Review RN in Camden, Maine, 04843!

Pay Information

$2,428 per week

About The Position

The Registered Nurse (RN) – Utilization Review (UR) is responsible for ensuring that healthcare services provided to patients are medically necessary, appropriate, and efficient. The RN in this role works with healthcare providers, insurance companies, and patients to review medical records, treatment plans, and clinical data to determine the appropriate level of care and ensure compliance with healthcare policies and regulations. This role requires a strong understanding of clinical care, health insurance guidelines, and hospital operations to make informed decisions that optimize patient care and resource utilization.

Key Responsibilities :

Utilization Review and Clinical Evaluation :

• Review patient medical records, treatment plans, and clinical data to assess the appropriateness of the care being provided and the necessity for continued hospitalization or services.
• Assess the medical necessity of procedures, tests, and treatments to ensure they align with established guidelines and criteria, such as those from the InterQual or Milliman Care Guidelines .
• Evaluate whether the care provided is appropriate, efficient, and meets the standards of care based on clinical evidence.

Collaboration with Healthcare Providers :

Insurance and Payer Interaction :

Monitoring of Length of Stay and Discharge Planning :

Compliance and Quality Assurance :

Documentation and Reporting :

Case Review and Decision-Making :

Education and Training :

28721044EXPPLAT

Job Requirements

Required for Onboarding

About Magnet Medical

We are new and nimble!  Even though our company is new we have over 30 years of experience in the Healthcare Staffing world. We have taken all the exceptional things we’ve learned over the years and put them into Magnet MEdical.  We are committed to providing the best Quality, Care, Service and Support to those who are providing care to the patients.  We work with Hospitals and Skilled Nursing Facilities across all 50 states. We can’t do our jobs without you so let’s work together to help you meet all of your goals!

We have recently merged two staffing companies to create Magnet Medical which allows us to offer more opportunities to our travelers!

Modalities we staff :

Since we are new and nimble, we are not set in our ways so that we can be flexible to our candidate and client needs. We are here when you need us!