Nevada Licensed Utilization Review Nurse

A company is looking for a Utilization Review Nurse (RN).

Key Responsibilities

Review and evaluate clinical cases for appropriateness against established criteria and medical evidence

Assess needs and coordinate resources to promote optimal health benefits and outcomes

Measure and review performance outcomes, proposing and implementing improvement processes

Required Qualifications

Graduation from an accredited nursing education program

Current, unrestricted, active RN license required

Minimum of three years of Utilization Review or Management / Case Management experience

Recent working knowledge of Interqual criteria and Milliman Care Guidelines required

Minimum of three years in clinical medical / surgical nursing practice within a hospital setting