Georgia Licensed Utilization Review Nurse

A company is looking for a Registered Nurse RN specializing in Utilization Review / Utilization Management for part-time weekend shifts. Key Responsibilities Evaluate and screen admissions to ensure appropriate patient status and level of care based on physician documentation Monitor patient progression and conduct continued stay reviews to verify medical necessity Secure authorization from payors by submitting clinical information justifying admissions and continued stays Required Qualifications Current RN Licensure in the State of Georgia Three to five years of experience as a Registered Nurse preferred Experience in Utilization Review or related Case Management is preferred Knowledge of State and Federal regulations and medical necessity criteria Proficient in using Microsoft Word, Excel, and Electronic Medical Records

Mar 10, 2025 - 16:34

A company is looking for a Registered Nurse RN specializing in Utilization Review / Utilization Management for part-time weekend shifts. Key Responsibilities Evaluate and screen admissions to ensure appropriate patient status and level of care based on physician documentation Monitor patient progression and conduct continued stay reviews to verify medical necessity Secure authorization from payors by submitting clinical information justifying admissions and continued stays Required Qualifications Current RN Licensure in the State of Georgia Three to five years of experience as a Registered Nurse preferred Experience in Utilization Review or related Case Management is preferred Knowledge of State and Federal regulations and medical necessity criteria Proficient in using Microsoft Word, Excel, and Electronic Medical Records