Utilization Review Nurse/Specialist

Utilization Review Nurse/Specialist

Utilization Review Nurse/Specialist to work full-time at Valle Vista Health System in Greenwood, IN.

The successful candidate will be responsible for the facilitation of clinical pertinence reviews on all patient admissions and continued stays, completion of certification/interfaces with managed care organization, external reviewers and other payors, in the absence of the UR Coordinator.


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REQUIREMENTS
Experience in patient assessment, treatment planning, case management or utilization review, and communication with external review organizations or comparable entities is preferred. Must be well versed in the use of psychotropic medications, have thorough knowledge of SI/IS (severity of illness/intensity of service) admission and continued stay criteria, have a good degree of assertiveness in order to actively advocate for the patient(s).

Must possess a degree in Nursing or Social Work and be a Registered Nurse or Licensed Clinical Worker