Utilization Review Nurse Specialist

1 week ago


Goleta, California, United States Cottage Health System Full time
Job Summary

The Utilization Review Nurse is a key member of the Cottage Health System team, responsible for ensuring the efficient and effective use of healthcare resources. This role involves conducting thorough reviews of patient care to identify opportunities for improvement and implementing strategies to optimize resource utilization.

Key Responsibilities
  • Conduct comprehensive utilization reviews to identify areas for improvement and develop strategies to optimize resource utilization.
  • Collaborate with healthcare teams to develop and implement care plans that promote efficient use of resources.
  • Monitor and analyze data to identify trends and areas for improvement in resource utilization.
  • Develop and maintain relationships with healthcare providers and stakeholders to ensure effective communication and collaboration.
  • Stay up-to-date with regulatory requirements and industry best practices to ensure compliance and optimal resource utilization.
Requirements
  • Current California Registered Nurse license in good standing.
  • Minimum of two years direct patient care RN experience in an acute care setting.
  • Ability to use electronic medical records systems and other clinical systems.
  • Strong analytical and problem-solving skills, with ability to think critically and make sound decisions.
  • Excellent communication and interpersonal skills, with ability to work effectively with diverse stakeholders.
Preferred Qualifications
  • Certification in Case Management.
  • Three years of experience as a Utilization Review Nurse in an acute care setting.


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