Utilization Review RN

6 days ago

Mustang OK United States Norman Regional Health System Full time
Overview:

The Utilization Review team is comprised of highly skilled Registered Nurses who ensure Norman Regional Health System follows a compliant review process to determine appropriateness of admission.

Responsibilities:
  • Utilization Review, Utilization Management, Advocacy and Education
  • Clinical Analysis and Data Management
  • Clinical Care Management/Coordination
  • Resource Management
  • Transition Management and Denial Prevention
  • Utilization Management
  • Psychosocial Management
  • Assist with establishing and review of departmental metrics on annual basis or as needed to insure mission, vision and strategic plan of NRHS.
Qualifications:

Education

  • Diploma or Associate’s degree (ADN) required, Bachelor of Science in Nursing (BSN), or Master's of Science in Nursing (MSN) preferred.

Experience

  • 3 years of acute RN experience required.
  • Prior Utilization Review experience preferred.
  • Current knowledge of medical necessity guidelines for hospitalization status preferred.

(Above requirements can be met by equivalent combination of education and experience)

 

Licensure/Certification

  • Current, RN license in the state of Oklahoma, Basic Life Support (BLS) training or retraining is required and must be maintained for the duration of employment.

Compensation/Benefits

  • $17.39-$28.40/hr depending on previous work experience.
  • Benefits include medical, dental, vision, short-term disability, long-term disability, life insurance, paid time off (PTO), paid holidays, tuition reimbursement, scholarship opportunities, retirement plans, free parking, and opportunities for advancement.

Utilization Review RN - Nights at Norman Regional Health System summary:

The Utilization Review RN works in a dedicated team to ensure compliance in hospital admission processes. This role encompasses a variety of responsibilities including clinical analysis, resource management, and coordination of care to enhance patient outcomes. Candidates should possess a relevant nursing degree and have a minimum of three years of acute RN experience, preferably with a background in Utilization Review.


Keywords:

Utilization Review, Registered Nurse, Healthcare, Clinical Analysis, Patient Advocacy, Resource Management, Care Coordination, Nursing, Health Systems, Medical Necessity

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