RN Utilization Review Specialist

Infirmary Health System • Mobile, AL

70d

About The Position

The position involves improving the overall quality and completeness of clinical documentation by performing concurrent reviews of medical records. The role ensures medical necessity and appropriateness of hospital admissions, providing education to physicians and others to enhance the capture of clinical severity for the level of service rendered. Additionally, the position identifies process improvement opportunities and supports the timely and accurate capture of measurements to improve patient outcomes.

Requirements

• Associate Degree in Nursing
• 2 of the most recent 4 years' working in an acute care setting
• Proficient in word processing and PC based spreadsheet programs
• Current Alabama RN license or Current Multi State RN License in accordance with Nurse Licensure Compact (NLC) for Alabama
• For specific areas CRRN (Certified Rehabilitation RN) is required (or eligibility)

Nice To Haves

• BSN
• Some background in management, clinical education or case management
• National certification applicable to area of clinical practice

Responsibilities

• Improves overall quality and completeness of clinical documentation by performing concurrent review of the medical record.
• Ensures medical necessity and appropriateness of hospital admissions.
• Provides education to physicians and others to improve the capture of clinical severity for the level of service rendered.
• Identifies process improvement opportunities.
• Supports the timely and accurate capture of measurements to improve patient outcomes.

What This Job Offers

• Industry: Hospitals
• Education Level: Associate degree
• Number of Employees: 1,001-5,000 employees