Hybrid Nurse Utilization Review Specialist III

UK King's Daughters; Lexington (KY); Hybrid; USD 39,000 - 55,000; Part time

Job summary

UK King's Daughters in Lexington, KY is seeking a Nurse Utilization Review Specialist III for a part-time, hybrid role. This position evaluates newly admitted patients, ensures accurate documentation, and secures required authorizations with payers.

It acts as a liaison among physicians, nursing staff, insurance providers, and social workers to support safe patient flow and reimbursement. The ideal candidate holds an ADN and an active RN license with 3–5 years of related experience.

Qualifications

• Assesses newly admitted patients for appropriate hospitalization and documentation.
• Ensures medical necessity is accurately documented for payer requirements.
• Coordinates with physicians and nursing staff to align care and documentation.

Responsibilities

• Assesss all newly admitted patients for appropriate hospitalization and level of care.
• Collaborates with physicians to ensure accurate documentation and necessary authorizations.
• Liaises with insurance providers to obtain timely authorizations for continued hospitalization.
• Participates in discharge planning and coordinates post-acute services.

Skills

Care coordination

Documentation accuracy

Interdisciplinary collaboration

Medical necessity understanding

Education

Associate Degree - ADN

RN license

Tools

EHR systems

Job description

UK King's Daughters in Lexington, KY is seeking a Nurse Utilization Review Specialist III for a part-time, hybrid role. This position evaluates newly admitted patients, ensures accurate documentation, and secures required authorizations with payers.

It acts as a liaison among physicians, nursing staff, insurance providers, and social workers to support safe patient flow and reimbursement. The ideal candidate holds an ADN and an active RN license with 3–5 years of related experience.