North Carolina Licensed Utilization Review Nurse

A company is looking for a Utilization Review Nurse. Key Responsibilities Evaluate cases for medical necessity and compliance with policies and regulations Communicate with clinical and non-clinical staff to coordinate care and document review outcomes Assess cases for secondary review by the Medical Director and coordinate peer-to-peer reviews as needed Required Qualifications Registered Nurse (RN) with 3 years of clinical experience or Licensed Practical Nurse (LPN) with 5 years of clinical experience For Behavioral Health roles, applicable licensure with a minimum of 3 years of clinical experience may be considered Must possess and maintain a valid clinical license (NC or compact multi-state licensure)

Apr 16, 2025 - 17:45

A company is looking for a Utilization Review Nurse. Key Responsibilities Evaluate cases for medical necessity and compliance with policies and regulations Communicate with clinical and non-clinical staff to coordinate care and document review outcomes Assess cases for secondary review by the Medical Director and coordinate peer-to-peer reviews as needed Required Qualifications Registered Nurse (RN) with 3 years of clinical experience or Licensed Practical Nurse (LPN) with 5 years of clinical experience For Behavioral Health roles, applicable licensure with a minimum of 3 years of clinical experience may be considered Must possess and maintain a valid clinical license (NC or compact multi-state licensure)