Nurse Utilization Review Pro — Hybrid

St Claire; Lexington (KY); Hybrid; USD 65,000 - 85,000; Part time

Job summary

UK St. Claire in Lexington, KY, is seeking a Nurse Utilization Review Specialist III for a part-time, hybrid role.

You will evaluate admissions for appropriate hospitalization, ensure documentation accuracy, and coordinate with physicians, nursing staff, and payers to secure authorizations and ensure proper care transitions. Responsibilities include discharge planning collaboration and liaison with Medicare/Medicaid to meet medical necessity and payer requirements, with emphasis on quality

Qualifications

• ADN required for position.
• Nursing license or eligible to practice.
• 3–5 years of related experience in utilization review or inpatient care.

Responsibilities

• Assess newly admitted patients for appropriate hospitalization and level of care.
• Collaborate with physicians on patient status and required documentation.
• Liaise with insurance providers to obtain authorizations and coordinate post-acute services.
• Support discharge planning and post-acute services coordination.

Skills

Communication

Care coordination

Discharge planning

Education

Associate Degree ADN

Job description

UK St. Claire in Lexington, KY, is seeking a Nurse Utilization Review Specialist III for a part-time, hybrid role.

You will evaluate admissions for appropriate hospitalization, ensure documentation accuracy, and coordinate with physicians, nursing staff, and payers to secure authorizations and ensure proper care transitions. Responsibilities include discharge planning collaboration and liaison with Medicare/Medicaid to meet medical necessity and payer requirements, with emphasis on quality