PRN Utilization Review Nurse Reviewer - RN

Posted 8 days agoViewed

💎 Seniority level: Junior, 2 years minimum clinical nursing experience is required. One year of previous experience in Utilization Management is required.

📍 Location: United States

🔍 Industry: Healthcare, Insurance Claims Management

🏢 Company: Dane Street, LLC

🗣️ Languages: English

⏳ Experience: 2 years minimum clinical nursing experience is required. One year of previous experience in Utilization Management is required.

🪄 Skills: Microsoft AccessMicrosoft Excel

Requirements:

Holds an unrestricted LVN/RN license from an accredited vocational nursing program or nursing degree from an accredited college.
A background in medical or clinical practice through education, training, or professional engagement.
Proficient in both written and spoken communication and interpersonal skills.
Skilled in handling multiple tasks and adjusting swiftly in a dynamic office setting.
Experienced with Microsoft tools such as Word, Excel, PowerPoint, and Outlook.

Responsibilities:

Conduct assessments of medical services to validate their appropriateness using established criteria and guidelines.
Examine and evaluate patient records to verify the quality of patient care and the necessity of provided services.
Offer clinical expertise and serve as a clinical reference for non-clinical staff members.
Input and manage essential clinical details within various medical management platforms.
Communicate effectively with management teams, physicians, and the Medical Director to foster high-quality patient care.

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