Utilization Review Nurse

5 days ago

Everett WA USA, United States Providence Full time
Job Summary

We are seeking a skilled Utilization Review Nurse to join our team at Providence Regional Medical Center Everett. As a Utilization Review Nurse, you will play a critical role in ensuring that patients receive the most appropriate and cost-effective care.

Key Responsibilities
  • Conduct thorough reviews of patient care plans to ensure that they are medically necessary and align with hospital policies and procedures.
  • Collaborate with healthcare teams to identify opportunities for cost savings and quality improvement.
  • Develop and implement strategies to reduce length of stay and improve patient outcomes.
  • Provide education and training to healthcare staff on utilization management best practices.
  • Participate in quality improvement initiatives to enhance patient care and reduce costs.
Requirements
  • Bachelor's Degree in Nursing (BSN) or higher.
  • Current Washington Registered Nurse License.
  • At least 5 years of experience as an RN in an acute care setting or recent utilization management experience.
Preferred Qualifications
  • Experience with Interqual or Milliman Criteria.
  • Care Management, medical insurance, or discharge planning experience.
About Providence

Providence is a not-for-profit health system that has been serving the Pacific Northwest since 1856. We are committed to providing high-quality, patient-centered care to our communities. Our award-winning medical centers offer a full range of services, including cancer, cardiology, neurosciences, orthopedics, women's services, emergency and trauma care, pediatrics, and neonatal intensive care.

We are proud to be an Equal Opportunity Employer and are committed to creating a diverse and inclusive workplace. We believe that diversity makes us stronger and are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.

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