Licensed Utilization Review Nurse

A company is looking for a Utilization Review Nurse.

Key Responsibilities

Perform prospective, concurrent, and retrospective utilization reviews using evidence-based guidelines

Evaluate severity of illness and intensity of service at the time of inpatient admission

Maintain accurate records of utilization review activities and ensure compliance with regulations

Required Qualifications

Licensed RN or Associate degree in Nursing required

Minimum of two to three years of varied clinical experience required

Managed care experience preferred

InterQual experience is required

Ability to read and interpret documents and make clinical decisions based on evidence-based criteria