Registered Nurse - Utilization Review, Tuba City, AZ

Mobile Health Team•Tuba City, AZ

1d•$39•Onsite

About The Position

Mobile Health Team Inc. is seeking an experienced Registered Nurse- Utilization Review for a 13-week travel assignment in Tuba City, AZ. This role involves ensuring patients receive appropriate care by verifying medical necessity, confirming patient status, and monitoring the need for services. The position also focuses on reducing unnecessary length of stay, preventing delays, and supporting accurate clinical documentation for proper reimbursement. The nurse will coordinate with providers on discharge planning and transitions, manage resource use to control costs, communicate with payers to prevent denials, and ensure compliance with CMS and Joint Commission requirements. This role is crucial for aligning patient care with quality standards and reimbursement rules, impacting patient outcomes, hospital efficiency, and financial performance.

Requirements

Three (3) years of clinical nursing experience performing direct patient care with at least 2 years in an Inpatient setting on a medical-surgical unit, PACU, or higher acuity Inpatient unit (ICU, Step-Down, Telemetry, etc.) or home health (direct care) clinical experience qualification may be determined by hiring manager/director.
Must demonstrate knowledge of case management, purchased referred care and utilization review processes.
Must demonstrate knowledge of electronic health record systems.
A valid, current, full and unrestricted Professional Nursing License to practice as a Registered Nurse (RN) in any state of the United States of America, The Commonwealth of Puerto Rico, or a territory of the United States
Must have and maintain current Basic Life Support (BLS) certification during employment
Effective team skills including interaction, support, and respect are required.
Strong organizational skills and ability to multitask
Willingness to participate in continuing education and training programs
Strong attention to detail and ability to work independently
Excellent communication skills , professionalism, and reliability
Ability to learn and apply basic computer skills including locating and opening documents, completing forms, opening and sending e-mail messages.
Drug screen and background check (facility required)
Additional facility onboarding forms as assigned

Responsibilities

Ensures that patients receive appropriate care by verifying medical necessity, confirming the correct patient status, and monitoring the ongoing need for services while working to reduce unnecessary length of stay and prevent delay
Support accurate clinical documentation for proper reimbursement
Coordinate with providers and the care team on discharge planning and transitions
Manage resource use to control costs, communicate with payers to prevent denials
Ensure compliance with CMS and Joint Commission requirements while contributing to reporting and quality improvement efforts
Serve as a key liaison between clinical care, finance, and regulatory requirements, helping align patient care with both quality standards and reimbursement rules
Make direct impact on patient outcomes, hospital efficiency, and the organization’s financial performance