Utilization Review RN

Memorial Hospital - Chattanooga • Chattanooga, TN

3d • $31 - $46

About The Position

As a Utilization Management Professional, you will help ensure healthcare efficiency and quality by supporting sound clinical decision-making, regulatory compliance, and responsible resource utilization. You will review medical records, authorize services, and prepare cases for physician review in partnership with utilization management teams. You will monitor patient care for appropriateness, quality, and cost-effectiveness, applying established criteria.

Requirements

• At least two years of acute hospital clinical experience, or a master's degree in Case Management or a Nursing field in lieu of one year of experience.
• An RN license in the state or states covered.
• BLS certification within three months of hiring.

Nice To Haves

• Graduation from an accredited school of nursing with a Bachelor of Science in Nursing (BSN), or a related healthcare field.
• At least five years of nursing experience.
• Certified Case Manager (CCM), Accredited Case Manager (ACM-RN), or UM certification.

Responsibilities

• Review medical records.
• Authorize services.
• Prepare cases for physician review in partnership with utilization management teams.
• Monitor patient care for appropriateness, quality, and cost-effectiveness.
• Apply established criteria to support clinical decisions and responsible resource utilization.

What This Job Offers

• Job Type: Full-time