Medical Utilization Review Specialist

5 days ago


St Louis, Missouri, United States BJC HealthCare Full time
About the Role

BJC HealthCare is seeking a dedicated Registered Nurse to lead our Utilization Review team. As a key member of our nursing department, you will play a vital role in ensuring that our patients receive high-quality care.

In this position, you will serve as a clinical resource facilitator to our care coordination department, providing expertise on level of care/medical necessity, progression of care, and care transition processes. You will also work closely with department management to ensure that designated aspects of care coordination are functioning at the highest quality.

As a subject matter expert, you will provide guidance and support to team members involved in care coordination, helping them to develop their skills and knowledge. Additionally, you will conduct ongoing audits to ensure staff competency and coordinate special projects as needed.



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