Pediatric Utilization Review Lead Nurse (Hybrid)

Connecticut Children's Medical Center; Hartford (CT); Hybrid; USD 90,000 - 120,000; Full time

Job summary

Connecticut Children’s is seeking a Center for Care Coordination-Team Lead Utilization Review Nurse to oversee UR nurses, supervise scheduling, and lead performance initiatives in a hybrid Hartford setting.

Responsibilities include chart reviews, policy updates, onboarding, and collaboration with care teams to improve patient care and resource utilization aligned with CMS and payer requirements.

Qualifications

• Bachelor of Science in Nursing (BSN) required.
• Experience as a registered nurse in healthcare setting preferred.
• Knowledge of utilization review and case management processes is advantageous.

Responsibilities

• Provide day-to-day supervision of UR nurses and oversee scheduling.
• Lead policy review, onboarding, and performance evaluation activities.
• Develop and track metrics to improve utilization and patient care outcomes.
• Coordinate provider education on medical record documentation and appropriate level of care.
• Collaborate with discharge planning and care teams to optimize resource use.

Education

BSN

Job description

Connecticut Children’s is seeking a Center for Care Coordination-Team Lead Utilization Review Nurse to oversee UR nurses, supervise scheduling, and lead performance initiatives in a hybrid Hartford setting.

Responsibilities include chart reviews, policy updates, onboarding, and collaboration with care teams to improve patient care and resource utilization aligned with CMS and payer requirements.