RN Utilization Management – Evening Shift, Bonus & Benefits

St. Luke's Health System; Meridian (ID); On-site; USD 70,000 - 100,000; Full time

Benefits offered by this job

Fully Benefitted

Sign On Bonus Eligible

On-site massages

On-site counseling via EAP

Personify Health Wellness tool

Career development / formal training

Job summary

St. Luke’s Health System seeks a Clinical Review Nurse to join our Meridian team. You will review medical necessity for admissions, length of stay, and potential denial issues, applying criteria with clinical expertise to determine services required.

We offer intensive paid training, full benefits, a sign-on bonus eligible, and a supportive environment with on-site wellness resources. Requires Idaho RN license and 3 years' utilization management experience (BSN) or 5 years (ASN).

Qualifications

• Bachelor of Nursing or Associate of Nursing Degree.
• Experience in RN or utilization management: 3 years (BSN) or 5 years (ASN).
• Current RN license in Idaho.

Responsibilities

• Reviews the medical necessity of admission, continued hospitalization, length of stay, and potential denial of payment issues.
• Applies established criteria and clinical expertise to determine medical necessity of services.
• Communicates results to primary care team, specialty providers, vendors and members in compliance with regulatory and contractual requirements.

Skills

Utilization review

RN clinical judgment

Communication

Education

BSN

ASN

Job description

St. Luke’s Health System seeks a Clinical Review Nurse to join our Meridian team. You will review medical necessity for admissions, length of stay, and potential denial issues, applying criteria with clinical expertise to determine services required.

We offer intensive paid training, full benefits, a sign-on bonus eligible, and a supportive environment with on-site wellness resources. Requires Idaho RN license and 3 years' utilization management experience (BSN) or 5 years (ASN).