Medical Review Nurse

2 weeks ago


Columbus, Ohio, United States Trinity Health Full time
About the Job

The Utilization Review Nurse at Trinity Health is responsible for ensuring that authorization requests and provider or member inquiries are handled appropriately within established timeframes. This position requires strong clinical assessment and analytical skills, effective communication, and the ability to work collaboratively with providers and medical directors.

In this role, you will perform clinical reviews and notify providers and members of decisions. You will also partner with provider partners to improve utilization review processes and provide exceptional customer service.

Responsibilities:

  • Perform clinical reviews and notify providers and members
  • Partner with provider partners on utilization review processes
  • Provide exceptional customer service
  • Collaborate with management to promote improvements in work processes

Qualifications:

  • Graduate from a school of nursing with a Baccalaureate degree preferred
  • Current license to practice as a registered nurse in the State of Ohio
  • Minimum 3-5 years nursing experience and knowledge of the utilization review process

Estimated Salary: $65,000 - $85,000 per year, depending on experience and qualifications.

We offer a comprehensive benefits package, including medical, dental, and vision coverage, retirement savings account with employer match, paid time off, and tuition/professional development reimbursement.



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