Utilization Review Lead
1 month ago
EliteCare Medical Staffing is seeking a highly skilled and experienced Utilization Review Lead - RN to join our team. As a key member of our Care Management Department, you will be responsible for overseeing, planning, directing, and coordinating Utilization Review services.
Key Responsibilities:- Provide leadership and guidance to other Utilization Review RNs and Social Workers.
- Lead multidisciplinary rounds to ensure safe discharge plans.
- Review medical records to determine and document medical necessity for inpatient and observation status.
- Identify issues and variations in utilization and escalate concerns to appropriate healthcare team members.
- Develop and coordinate discharge plans in collaboration with the healthcare team.
- Advocate for necessary services and funding to meet care plan goals.
- Arrange appropriate community services while adhering to state and federal health regulations.
- Current Registered Nurse (RN) license in the state of Washington.
- Bachelor's degree in Nursing preferred; equivalent experience may be considered.
- Minimum of [insert years] years of experience in Utilization Review or related field.
- Strong understanding of CMS regulations and compliance standards.
- Excellent communication, leadership, and interpersonal skills.
- Competitive salary based on experience.
- Comprehensive benefits package including health insurance, retirement plans, and paid time off.
At EliteCare Medical Staffing, we value passion for providing high-quality care. We offer a supportive environment where you can grow professionally. If you are ready to make a difference in patients' lives and advance your career, we encourage you to apply.
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Utilization Review Lead
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Anacortes, United States EliteCare Medical Staffing Full timeJob Description: RN Utilization Review LeadPosition Title: RN Utilization Review LeadLocation: Anacortes WADepartment/Unit: Utilization ReviewShift: 8 Hour VariableJob Purpose:The Utilization Review RN Lead is responsible for the oversight planning direction and coordination of Utilization Review (UR) services within the Care Management Department....
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