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Clinical Utilization Specialist

2 months ago

Alamogordo, New Mexico, United States AMN Healthcare Full time
Job Summary

We are seeking a skilled Utilization Review RN to join our team at AMN Healthcare. As a key member of our healthcare organization, you will play a critical role in ensuring the efficient use of resources and providing high-quality patient care.

Key Responsibilities
  • Initiate discharge planning for assigned patients within 24 hours of admission
  • Revised discharge planning as indicated by changes in the patient's condition and circumstances
  • Arrange for post-discharge needs of patients
  • Clearly and accurately document all patient/family interventions and interactions
  • Monitor for efficient use of resources and report to Director when there are actual or potential sources of under- or over-utilization
  • Collaborate with providers, nurses, patients, families, and other care providers in the development and implementation of patient care plans
  • Communicate with providers regarding patient status and assist in ensuring proper placement of patient
  • Conduct utilization review using nationally recognized medical necessity criteria and document the review
  • Refer cases for second-level reviews when medical necessity criteria are not met
Requirements
  • Five years recent experience in an acute care facility required
  • Knowledge of and experience with InterQual Level of Care Criteria, experience in automated InterQual preferred
Benefits

As a valued member of our team, you will enjoy a comprehensive benefits package, including medical, dental, and vision benefits, earned time off, paid holidays, paid continuing education time, 401(K) retirement planning, short-term disability, life insurance, and paid jury duty. You will also have access to the largest network of facilities and providers in the country, as well as industry-experienced workforce management team and licensure and certification reimbursement.