Utilization Review RN

20 hours ago


Lexington, 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 Associates 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 - Nights at Norman Regional Health System is responsible for ensuring compliance in the review process for hospital admissions. This role involves clinical analysis, resource management, and care coordination to prevent denials and improve patient outcomes. A qualified candidate will possess an ADN, BSN, or MSN, along with experience in acute care and utilization review. Keywords: Utilization Review, Registered Nurse, Healthcare, Clinical Management, Patient Advocacy, Care Coordination, Oklahoma RN License, Medical Necessity, BLS Certification, Healthcare Compliance



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