Utilization Review Registered Nurse_Days
About The Position
As an integrated care manager, specializing in Utilization review, the registered nurse will be responsible for utilization review services within the scope of licensure. Conducts primary function of prior authorization for inpatient and outpatient reviews both initial and concurrent continued stay review. Reviews for appropriateness of treatment setting to ensure compliance with applicable criteria, and regulatory requirements. Responsible for written and /or verbal communication of pertinent clinical information. Virginia Remote, must be available to come into Virginia Beach office as required
Requirements
- Minimum of 3 years acute care experience
- Registered Nurse Required
- Verbal and Written Communication
- Critical Thinking
- Proficiency with basic computer skills
- VA RN License (VABON) or North Carolina RN License (NCBON)
- RN diploma, RN Associate Degree, RN Bachelor Level Degree or RN Master Level
Responsibilities
- utilization review services within the scope of licensure
- Conducts primary function of prior authorization for inpatient and outpatient reviews both initial and concurrent continued stay review
- Reviews for appropriateness of treatment setting to ensure compliance with applicable criteria, and regulatory requirements
- Responsible for written and /or verbal communication of pertinent clinical information
Benefits
- Medical, Dental, Vision plans
- Adoption, Fertility and Surrogacy Reimbursement up to $10,000
- Paid Time Off and Sick Leave
- Paid Parental & Family Caregiver Leave
- Emergency Backup Care
- Long-Term, Short-Term Disability, and Critical Illness plans
- Life Insurance
- 401k/403B with Employer Match
- Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education
- Student Debt Pay Down – $10,000
- Reimbursement for certifications and free access to complete CEUs and professional development
- Pet Insurance
- Legal Resources Plan
- Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
Number of Employees
5,001-10,000 employees
