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Oregon Licensed Utilization Review Nurse
A company is looking for a Utilization Review Nurse (RN). Key Responsibilities Monitor utilization practices from preadmission to discharge to ensure cost-effective resource use and quality patient care Conduct reviews of medical records to verify documentation meets medical necessity criteria according to regulatory guidelines Collaborate with care team members to improve documentation accuracy and manage admission status Required Qualifications and Education Registered Nurse (RN) with a minimum of 2 years of experience in utilization review in an acute care setting Experience with Epic and InterQual systems Knowledge of payor policies for medical necessity criteria regarding observation and inpatient care Able to conduct a minimum of 20 case reviews per shift after training Availability to work between 8am and 4pm PST, including one weekend day every 4-5 weeks
A company is looking for a Utilization Review Nurse (RN).
Key Responsibilities
Monitor utilization practices from preadmission to discharge to ensure cost-effective resource use and quality patient care
Conduct reviews of medical records to verify documentation meets medical necessity criteria according to regulatory guidelines
Collaborate with care team members to improve documentation accuracy and manage admission status
Required Qualifications and Education
Registered Nurse (RN) with a minimum of 2 years of experience in utilization review in an acute care setting
Experience with Epic and InterQual systems
Knowledge of payor policies for medical necessity criteria regarding observation and inpatient care
Able to conduct a minimum of 20 case reviews per shift after training
Availability to work between 8am and 4pm PST, including one weekend day every 4-5 weeks
