Onsite Utilization Review RN — Acute Care Expert

Fusion HCR; Las Vegas (NV); On-site; USD 80,000 - 100,000; Full time

Benefits offered by this job

Competitive pay

Stable, high-demand role

Collaborative healthcare environment

Job summary

A healthcare provider is hiring a Utilization Review Nurse for an on-site position in Las Vegas, Nevada. This role involves reviewing patient admissions for medical necessity and ensuring compliance with payer guidelines. Candidates should have an active RN license in Nevada, over 5 years of acute care nursing experience, and at least 3 years in Utilization Review. The position offers competitive pay and a collaborative healthcare environment.

Qualifications

• 5+ years acute care nursing experience.
• 3+ years Utilization Review experience.
• 3+ years discharge planning experience (acute care).

Responsibilities

• Review admissions using InterQual and/or Milliman criteria.
• Evaluate medical necessity, level of care, and documentation accuracy.
• Ensure compliance with Medicare, Medicaid, and regulatory guidelines.

Skills

Utilization Review

InterQual

Acute Care Nursing

Documentation Accuracy

Discharge Planning

Education

Active RN license (Nevada)

Tools

Milliman Guidelines

Job description

A healthcare provider is hiring a Utilization Review Nurse for an on-site position in Las Vegas, Nevada. This role involves reviewing patient admissions for medical necessity and ensuring compliance with payer guidelines. Candidates should have an active RN license in Nevada, over 5 years of acute care nursing experience, and at least 3 years in Utilization Review. The position offers competitive pay and a collaborative healthcare environment.