Job Summary
A company is looking for a RN Utilization Management Care Reviewer.
Key Responsibilities
- Evaluate patient care and conduct reviews to identify issues that may delay services
- Collaborate with case management teams to ensure safe and proper discharge coordination
- Assess inpatient services for compliance with regulations and analyze clinical services against evidence-based guidelines
Required Qualifications
- Bachelor's degree in nursing or equivalent working knowledge
- Active, unrestricted State Registered Nursing (RN) license in good standing
- Five years of clinical nursing experience or equivalent working knowledge
- Proficiency in computer usage, including Microsoft Suite and medical record review
- MCG certification or ability to obtain within six months of hire
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