RN Utilization Review
HH Health System•Huntsville, AL
About The Position
Utilization management is the analysis of the medical necessity, acute care appropriateness, and efficiency of medical services and procedures in the hospital setting. Utilization review is the assessment for medical necessity, both for admission to the hospital as well as continued stay. This function ensures that services are not only appropriate, but ensures that an authorization for services is obtained from payer, if required, and that documentation supports the care delivered in such a way that minimizes the risk of denials after discharge.
Requirements
- Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) or Licensed Registered Nurse
- 2 years previous nursing experience
- Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN) or Licensed Registered Nurse
- Data entry skills
- Demonstrable skills with Google Docs, Google Sheets, Microsoft Suite and email applications.
Nice To Haves
- Bachelors Science Nursing or higher
- Utilization Review or Case Management experience
- ACM or CCM Certification
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What This Job Offers
Career Level
Mid Level
Education Level
Associate degree
