Utilization Review RN (FT, Days)

PCMH Careers • Tell City, IN

2d • Onsite

About The Position

This is a full-time, day shift position for a Utilization Review Registered Nurse. The role requires a graduate of an accredited school of nursing, licensed to practice in Indiana, and current in BLS. Two years of hospital clinical experience is necessary, along with knowledge of medical standards of care, state and federal utilization review laws, and healthcare regulations. The position involves working primarily in an office setting with some chart review and staff meetings. The nurse will handle interruptions, variable workflows, and confidential information, utilizing computers and various software. Critical thinking, decisive judgment, time management, and communication skills are essential.

Requirements

• Graduate of an accredited school of nursing
• Licensed to practice as a Registered Nurse in the state of Indiana
• Current in BLS
• Two years of hospital clinical experience
• Knowledge of medical standards of care
• Knowledge of state and federal utilization review laws
• Knowledge of healthcare regulations
• Use computers
• Use electronic medical records (EMR)
• Use spreadsheets
• Use word processing software
• Use email software

Nice To Haves

• Prior experience in utilization review
• Prior experience in case management
• Prior experience in discharge planning
• Prior experience with prospective payment systems (DRGs)
• Prior experience with the CMS Medicare Swing Bed Program

Responsibilities

• Review charts
• Meet with staff
• Handle frequent interruptions
• Manage variable workflows
• Handle confidential information in volatile situations
• Apply critical thinking
• Apply decisive judgment
• Apply time management skills
• Apply basic math skills
• Read, write legibly, speak clearly
• Follow instructions
• Handle inquiries or complaints professionally

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed