Registered Nurse Utilization Review

Job Summary

A company is looking for a Utilization Review RN, Full-Time, with multiple shifts available.

Key Responsibilities

• Review and evaluate electronic medical records for emergency 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
• Intermediate experience with InterQual and/or MCG criteria
• Proficiency in medical record review in an electronic medical record (EMR)