ApplyUtilization Management Nurse Reviewer (Weekend Shift)
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💎 Seniority level: Junior, 2 yrs minimum clinical nursing experience; One year of previous experience in Utilization Management
📍 Location: United States
🔍 Industry: Healthcare
🏢 Company: Dane Street, LLC
🗣️ Languages: English
⏳ Experience: 2 yrs minimum clinical nursing experience; One year of previous experience in Utilization Management
🪄 Skills: LeadershipMicrosoft AccessCross-functional Team LeadershipOperations ManagementCommunication SkillsAnalytical SkillsCollaborationMicrosoft ExcelProblem SolvingMicrosoft OfficeAttention to detailOrganizational skillsTime ManagementWritten communicationMultitaskingMicrosoft Office Suite
Requirements:
- Holds an unrestricted LVN/RN license from an accredited program.
- Minimum 2 years of clinical nursing experience.
- 1 year of experience in Utilization Management.
- Proficient in written and spoken communication.
- Skilled in Microsoft tools (Word, Excel, PowerPoint, Outlook).
- Organizational skills and attention to detail.
Responsibilities:
- Conduct assessments of medical services to validate their appropriateness using established criteria and guidelines.
- Examine and evaluate patient records for quality of care and necessity of services.
- Offer clinical expertise to non-clinical staff.
- Manage clinical details within medical management platforms.
- Stay updated with regulatory requirements and state standards.
- Communicate with management teams, physicians, and Medical Director to foster patient care.
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