Utilization Review Nurse - RN
Company: VirtualVocations
Location: Racine
Posted on: November 7, 2024
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Job Description:
A company is looking for a Utilization Review Nurse to perform
utilization review work for emergency admissions and continued stay
reviews.
Key Responsibilities
Review electronic medical records of emergency department
admissions for medical necessity using InterQual or MCG
criteria
Participate in telephonic discussions with emergency department
physicians regarding documentation and admission status
Enter clinical review information into the system for transmission
to insurance companies for authorization
Required Qualifications
Current RN licensure
At least 3 years of clinical experience in an acute care setting
(emergency room, critical care, or medical/surgical nursing)
At least 2 years of utilization management experience in acute
admission and concurrent reviews
Intermediate level experience with InterQual and/or MCG criteria
within the last two years
Proficiency in medical record review in an electronic medical
record (EMR)
Keywords: VirtualVocations, Carol Stream , Utilization Review Nurse - RN, Healthcare , Racine, Illinois
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