State Licensed Utilization Review Nurse
VirtualVocationsMission Viejo, California, United States12 hours ago
Job type
- Full-time
Job description
A company is looking for a Utilization Review Nurse (PRN).
Key Responsibilities
Review and evaluate electronic medical records for emergency admissions to assess medical necessity
Apply clinical guidelines to ensure proper utilization of healthcare resources and participate in discussions with physicians
Enter clinical review information for insurance authorization and analyze utilization patterns
Required Qualifications
Current and unrestricted RN license
At least 3 years of clinical experience in an acute care setting
Minimum of 2 years of utilization management experience
Intermediate experience with InterQual and / or MCG criteria
Proficiency in medical record review in an electronic medical record (EMR) system
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Utilization Review Nurse • Mission Viejo, California, United States
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