Nevada Licensed Utilization Review Nurse

Job Summary

A company is looking for a Utilization Review Nurse (RN).

Key Responsibilities

• Review and evaluate clinical cases for appropriateness against established criteria and medical evidence
• Assess needs and coordinate resources to promote optimal health benefits and outcomes
• Measure and review performance outcomes, proposing and implementing improvement processes

Required Qualifications

• Graduation from an accredited nursing education program
• Current, unrestricted, active RN license required
• Minimum of three years of Utilization Review or Management/Case Management experience
• Recent working knowledge of Interqual criteria and Milliman Care Guidelines required
• Minimum of three years in clinical medical/surgical nursing practice within a hospital setting