Utilization Review RN

2 weeks ago

Yukon 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:

As a Utilization Review RN, I ensure that the Norman Regional Health System adheres to appropriate admission criteria through comprehensive clinical analysis and resource management. My role involves utilization management, advocacy, education, and the coordination of clinical care, alongside overseeing departmental metrics to align with the organization’s mission and strategic goals. I hold a current RN license and have over three years of acute nursing experience, with expertise in managing medical necessity guidelines and denial prevention.

Keywords:

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

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