Remote Utilization Review RN – Care Coordination Expert

CoxHealth; United States; À distance; USD 70 000 - 90 000; Plein temps

Avantages offerts par ce poste

Medical, Vision, Dental, Retirement w/

Employer Match

Résumé du poste

CoxHealth, a leading health system serving multiple counties in Missouri, seeks a Utilization Review Nurse RN. You will collaborate with physicians and care teams to ensure high-quality, cost-effective care while reviewing medical necessity and level of care for inpatient or observation services.

Strong nursing background and knowledge of utilization criteria are essential. The role requires at least 3 years of hospital experience, and the nurse will support education on resource use and

Qualifications

• Graduate of an accredited school of nursing.
• Minimum of 3 years hospital experience.

Responsabilités

• Collaborates with physicians and multidisciplinary team to facilitate progression-of-care.
• Monitors patient progress and ensures plan of care is high quality, evidence-based, and cost-effective.
• Reviews inpatient vs observation criteria and communicates with payers per contractual obligations.
• Provides education and information on resource utilization and coverage determinations.

Connaissances

Interpersonal skills

Communication

Computer skills

Team collaboration

Formation

RN license (MO)

Bachelor’s in Nursing (preferred)

Description du poste

CoxHealth, a leading health system serving multiple counties in Missouri, seeks a Utilization Review Nurse RN. You will collaborate with physicians and care teams to ensure high-quality, cost-effective care while reviewing medical necessity and level of care for inpatient or observation services.

Strong nursing background and knowledge of utilization criteria are essential. The role requires at least 3 years of hospital experience, and the nurse will support education on resource use and