Utilization Review Nurse

2 weeks ago


Rockford, Illinois, United States Hines & Associates Inc Full time
Job Description

Hines & Associates Inc. is seeking a skilled Utilization Review Nurse to join our team. As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive the necessary medical care while minimizing costs.

About the Role:

This position involves reviewing patient medical records to determine the medical necessity of proposed treatments and procedures. You will work closely with healthcare providers, case managers, and other stakeholders to ensure that patients receive the best possible care.

Responsibilities:

  • Conduct thorough reviews of patient medical records to determine medical necessity.
  • Communicate with healthcare providers and case managers to gather additional information.
  • Make informed decisions regarding medical necessity based on clinical guidelines and regulations.
  • Document all reviews and decisions in a timely and accurate manner.
  • Collaborate with other teams to ensure seamless communication and coordination.

Requirements:

  1. Registered Nurse with a valid, unrestricted license in the state or territory of the United States where employed.
  2. Minimum of 3 years recent acute clinical practice required, 5 years preferred.
  3. Managed care, disability, or workers compensation experience helpful but not mandatory.
  4. Excellent communication and interpersonal skills.

What We Offer:

  • Competitive salary and benefits package.
  • Opportunities for professional growth and development.
  • Collaborative and dynamic work environment.

How to Apply:

If you are a motivated and detail-oriented nurse looking for a new challenge, please submit your application, including your resume and cover letter, to Hines & Associates Inc. We look forward to hearing from you



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