RN Utilization Review & Case Management

Marshall Medical Centers; Huntsville (AL); On-site; USD 55,000 - 75,000; Full time

Job summary

Marshall Medical Centers is seeking a qualified nurse for utilization management and utilization review within a hospital setting. This role ensures medical necessity and appropriateness of services, coordinates payer authorizations when required, and supports documentation to minimize denials after discharge.

Preferred candidates hold a BSN or higher, 2+ years of nursing experience, and may have ACM/CCM certification. Proficiency with Google Docs/Sheets and Microsoft Office is expected.

Qualifications

• Licensed practical, vocational, or registered nurse required.
• Preferred BSN or higher.
• Minimum 2 years of nursing experience.
• Utilization Review or Case Management experience preferred.
• ACM or CCM certification preferred.

Responsibilities

• Not specified in the posting.

Skills

Nursing experience

Utilization review

Case management

Education

LPN/LVN/RN (required)

BSN or higher (preferred)

Tools

Google Docs

Google Sheets

Microsoft Office

Email applications

Job description

Marshall Medical Centers is seeking a qualified nurse for utilization management and utilization review within a hospital setting. This role ensures medical necessity and appropriateness of services, coordinates payer authorizations when required, and supports documentation to minimize denials after discharge.

Preferred candidates hold a BSN or higher, 2+ years of nursing experience, and may have ACM/CCM certification. Proficiency with Google Docs/Sheets and Microsoft Office is expected.