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
Utilization Review Nurse • Dayton, Ohio, United States