Registered Nurse Concurrent Utilization Review

Tucson Medical Center; Tucson (AZ); On-site; USD 65,000 - 70,000; Full time

Benefits offered by this job

Family Style Atmosphere with a Supportive Team

Competitive Pay

Career Growth Opportunities

Tuition Reimbursement

Health and Wellness Coaching

Job summary

A local community hospital in Tucson is seeking a Registered Nurse for Concurrent Utilization Review. The role includes reviewing patient admission criteria, coordinating discharge plans, and securing necessary authorizations for care. Qualified candidates will possess an active RN license in Arizona and have substantial experience in acute care. This full-time position offers a supportive team environment with competitive pay and growth opportunities.

Qualifications

• Actively licensed RN in Arizona.
• Three years of RN nursing experience in acute care.
• Experience in case management or utilization review preferred.

Responsibilities

• Screen patients for admission criteria using InterQual criteria.
• Conduct reviews as per CMS guidelines.
• Communicate necessary information for service authorization with payors.

Skills

Communication

Clinical assessment

Resource utilization

Documentation

Education

Graduation from a qualified nursing program

Bachelor’s degree preferred

Job description

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Demonstrates fiscal responsibility related to patient needs, resource utilization, payer requirements and organizational goals. Screens patients for admission criteria (medical necessity/patient status/level of care) utilizing InterQual criteria and documenting the review in the CERME software system. Conducts reviews as established by CMS guidelines and Utilization Management processes. Secures authorization/certification for services by communicating necessary and requested information with payors. Communicates information that will impact the discharge plan to the Transitional Care Coordinator and Case Managers to ensure high quality care coordination. This position covers Fri/Sat/Sun from 9am to 9pm.

Tucson Medical Center (TMC) is Tucson’s only non-profit community owned hospital. Employees choose to work at TMC because of our of integrity, community, dedication, and compassion which we show through the exceptional care we provide to our patients and our community. Our passion for caring for the Tucson community has expanded over the last to include community partnerships, new medical specialties, and medical clinics to further provide the care our community deserves.

Why Join Tucson Medical Center?

Benefits

We don’t only care for our patients, we care for our TMC family too. As a member of our family you can expect to enjoy a wide variety of benefits. In addition to all the benefits you would expect from a leading medical facility (medical, dental, vision, 401K with match) we also provide:

• Family Style Atmosphere with a Supportive Team
• Competitive Pay
• Career Growth Opportunities
• Tuition Reimbursement
• Health and Wellness Coaching
  
  

Minimum Qualifications

EDUCATION: Graduation from a qualified, nationally-accredited nursing program required. Bachelor’s degree preferred.

EXPERIENCE: Three (3) years RN nursing experience, preferably in an acute care setting. Three (3) years experience working in a case management or utilization review role preferred.

LICENSURE OR CERTIFICATION: Active unrestricted RN license within the State of Arizona, or NLC.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Health Care Provider

• Industries

  Hospitals and Health Care

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