State Licensed Utilization Review Nurse

Job Summary

A company is looking for a Utilization Review Nurse - PRN.

Key Responsibilities

• Review and evaluate electronic medical records for emergency admissions and screen for medical necessity
• Apply evidence-based clinical guidelines to assess healthcare resource utilization
• 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
• At least 2 years utilization management experience in acute admission and concurrent reviews
• Intermediate level experience with InterQual and/or MCG criteria
• Proficiency in medical record review in an electronic medical record (EMR)