Utilization Review Nurse - Care Coordination Services
Montage Health•Monterey, CA
2d•$72 - $96•Onsite
About The Position
Under the leadership of the department director the Utilization Review Nurse facilitates quality care by screening the admission and continued stay of patients utilizing Intensity of Service/Severity of Illness criteria. The Utilization Nurse complies with regulatory requirements and supports systems and processes to meet regulations. Important dimensions of this position consist of quality, professional commitment, teamwork, interpersonal skills, safety, good public/customer relations and a broad clinical knowledge.
Requirements
- Must have 5 years current acute care hospital experience.
- Broad clinical expertise to evaluate patient diagnosis and treatment plan and outcomes utilizing established criteria.
- Effective communication and public relations skills.
- Ability to work as an integral member of the interdisciplinary assessment team.
- Strong organization skills.
- Knowledge of financial reimbursement — state, federal and commercial insurance requirements preferred.
- Knowledge of Government programs, rules and regulations, and commercial insurance requirements preferred.
- State of California RN license required.
Nice To Haves
- Bachelor’s degree in nursing preferred.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
