Utilization Review RN

7 days ago

Concho 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 plays a crucial role in ensuring efficient hospital admission processes by performing utilization review and management activities. With a background in acute care nursing, they focus on clinical analysis, resource management, and the prevention of denial during transitions of care. This position requires strong advocacy skills, knowledge of medical necessity guidelines, and an emphasis on ongoing education and departmental metrics.

Keywords:

Utilization Review, Registered Nurse, Clinical Analysis, Healthcare Management, Resource Management, Transition Management, Patient Advocacy, Nursing, BLS Certification, Acute Care

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