Registered Nurse Clinical Specialist

A company is looking for a UR Clinical Specialist (Remote). Key Responsibilities Evaluate the necessity and appropriateness of hospital services through admission and continued stay reviews Collaborate with healthcare providers to ensure compliance with utilization management policies and obtain necessary documentation Document utilization review activities and analyze trends to identify opportunities for process improvements Required Qualifications Associate Degree in Nursing required; Bachelor's Degree in Nursing preferred 2-4 years of clinical experience in utilization review, case management, or acute care nursing required 1-3 years of experience in care management preferred 1-2 years of experience in utilization management, payer relations, or hospital revenue cycle preferred RN - Registered Nurse - State Licensure required

Mar 27, 2025 - 18:18

A company is looking for a UR Clinical Specialist (Remote). Key Responsibilities Evaluate the necessity and appropriateness of hospital services through admission and continued stay reviews Collaborate with healthcare providers to ensure compliance with utilization management policies and obtain necessary documentation Document utilization review activities and analyze trends to identify opportunities for process improvements Required Qualifications Associate Degree in Nursing required; Bachelor's Degree in Nursing preferred 2-4 years of clinical experience in utilization review, case management, or acute care nursing required 1-3 years of experience in care management preferred 1-2 years of experience in utilization management, payer relations, or hospital revenue cycle preferred RN - Registered Nurse - State Licensure required