South Carolina Licensed Utilization Management Nurse

A company is looking for a Utilization Management RN II - Surgical. Key Responsibilities Conducts utilization reviews to ensure appropriate patient care based on severity of illness and required services Monitors patient charts and evaluates care concurrently with treatment Consults with multidisciplinary teams to communicate review results and ensure proper resource utilization for reimbursement Required Qualifications, Training, and Education Bachelor's degree in Nursing from an accredited institution Five years of nursing experience, including two years in utilization or case management within a hospital setting Licensure as a registered nurse in South Carolina or a compact state Preferred leadership experience and involvement in healthcare committees Familiarity with InterQual and/or MCG screening criteria is desired

Apr 17, 2025 - 18:04

A company is looking for a Utilization Management RN II - Surgical. Key Responsibilities Conducts utilization reviews to ensure appropriate patient care based on severity of illness and required services Monitors patient charts and evaluates care concurrently with treatment Consults with multidisciplinary teams to communicate review results and ensure proper resource utilization for reimbursement Required Qualifications, Training, and Education Bachelor's degree in Nursing from an accredited institution Five years of nursing experience, including two years in utilization or case management within a hospital setting Licensure as a registered nurse in South Carolina or a compact state Preferred leadership experience and involvement in healthcare committees Familiarity with InterQual and/or MCG screening criteria is desired