Clinical Utilization Review Nurse Specialist
2 weeks ago
Bjc Healthcare is seeking a highly skilled Clinical Utilization Review Nurse Specialist to join our team. This full-time position requires 80 hours of work per pay period, equivalent to two weeks. The schedule includes Monday through Friday, 8 a.m. to 4:30 p.m., as well as one Sunday every four weeks. This is a remote work opportunity, with no patient communication required.
Key Responsibilities:- Evaluate the appropriateness of patient care by reviewing and interpreting diagnostic test results
- Ensure optimal utilization of healthcare resources by evaluating the cost and quality of medical services provided by the medical team
- Analyze potential under- and over-utilization of healthcare resources to identify areas for improvement
- At least 2 years of experience in performing care for hospitalized patients as a staff nurse
- 2 years of experience in utilization review, including evaluating hospital admissions for medical necessity
- RN license in both Missouri and Illinois (or willingness to obtain a second license)
- EPIC experience is highly valued
Bjc Healthcare is a leading nonprofit healthcare organization in the United States, delivering services primarily in the greater St. Louis, southern Illinois, and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, Bjc serves patients and their families in urban, suburban, and rural communities through its 14 hospitals and multiple community health locations.
Benefits:- Comprehensive medical, dental, vision, life insurance, and legal services available on the first day of the month after hire date
- Disability insurance paid for by BJC
- Pension Plan*/403(b) Plan funded by BJC
- 401(k) plan with BJC match
- Tuition Assistance available on the first day
- BJC Institute for Learning and Development
- Health Care and Dependent Care Flexible Spending Accounts
- Paid Time Off benefit combines vacation, sick days, holidays, and personal time
- Adoption assistance
Estimated Salary: $65,000 - $85,000 per year.
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