PRN Utilization Review Nurse - Evening/Weekend

Brundage Group; Town of Florida (NY); On-site; USD 45,000 - 65,000; Full time

Job summary

Brundage Group seeks an experienced Utilization Review Nurse for PRN evening shifts at a New York hospital. You will perform admission reviews, assess patient status, and collaborate with physicians and care teams to optimise reimbursement and care quality.

The role requires RN licensure, 5+ years in acute care and utilization review, and familiarity with InterQual/MCG criteria. PRN hours and weekend requirements apply, with shift options of 4 or 8 hours.

Qualifications

• Graduate of an accredited nursing program with active RN license.
• BSN preferred for continued education and leadership opportunities.
• Certifications in case management are preferred (CCM/ACM/CMCN or CMGT-BC).

Responsibilities

• Perform hospital admission reviews to determine medical necessity and patient status (inpatient, observation, outpatient).
• Conduct continued stay reviews using approved clinical criteria and guidelines (InterQual/MCG).
• Evaluate clinical documentation for accuracy, completeness, and compliance with payer and regulatory requirements.
• Collaborate with physicians, case management, and leadership to communicate findings and recommendations.

Skills

Strong communication

Independent work

Adaptability

Fast-paced environment

Education

RN license

BSN preferred

CCM/ACM/CMCN/CMGT-BC

Tools

Electronic Health Records

Case Management Systems

Job description

Brundage Group seeks an experienced Utilization Review Nurse for PRN evening shifts at a New York hospital. You will perform admission reviews, assess patient status, and collaborate with physicians and care teams to optimise reimbursement and care quality.

The role requires RN licensure, 5+ years in acute care and utilization review, and familiarity with InterQual/MCG criteria. PRN hours and weekend requirements apply, with shift options of 4 or 8 hours.