Utilization Review RN

3 days ago

Oklahoma City 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 at Norman Regional Health System is responsible for overseeing the compliance of the admission review process by assessing clinical data and coordinating care management. This role involves conducting utilization management, advocating for patients, and preventing denials while ensuring alignment with departmental metrics. Candidates should possess a valid nursing license in Oklahoma along with significant acute care experience and familiarity with medical necessity guidelines.


Keywords:

Utilization Review, Registered Nurse, Clinical Management, Healthcare, Patient Advocacy, Nursing, Medical Necessity, Care Coordination, Admission Review, Oklahoma RN

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