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Utilization Review Nurse
A company is looking for a Utilization Review Nurse, PRN, Remote. Key Responsibilities Review and evaluate electronic medical records for emergency admissions and assess medical necessity using InterQual or MCG criteria Apply evidence-based clinical guidelines to ensure proper utilization of healthcare resources Participate in discussions with emergency department physicians regarding documentation and admission status Required Qualifications Current and unrestricted RN license At least 3 years clinical experience in an acute care setting, preferably in emergency room or critical care At least 2 years of utilization management experience in acute admissions and concurrent reviews Intermediate level experience with InterQual and/or MCG criteria within the last two years Proficiency in medical record review in an electronic medical record (EMR)
A company is looking for a Utilization Review Nurse, PRN, Remote.
Key Responsibilities
Review and evaluate electronic medical records for emergency admissions and assess medical necessity using InterQual or MCG criteria
Apply evidence-based clinical guidelines to ensure proper utilization of healthcare resources
Participate in discussions with emergency department physicians regarding documentation and admission status
Required Qualifications
Current and unrestricted RN license
At least 3 years clinical experience in an acute care setting, preferably in emergency room or critical care
At least 2 years of utilization management experience in acute admissions and concurrent reviews
Intermediate level experience with InterQual and/or MCG criteria within the last two years
Proficiency in medical record review in an electronic medical record (EMR)
