RN Utilization Review Specialist: Impactful Care

Wood County Hospital; Bowling Green (OH); On-site; USD 60,000 - 90,000; Part time

Benefits offered by this job

Great health, dental and vision plans

Competitive wages

Flexible spending accounts

Generous tuition reimbursement

Job summary

A regional healthcare provider in Bowling Green, Ohio, is seeking an RN for Utilization Review on a per diem basis. This role involves reviewing patient records for medical necessity, collaborating with healthcare teams, and ensuring adherence to clinical guidelines. A Bachelor's degree in Nursing is preferred along with a valid Ohio nursing license and a minimum of three years in acute care. Benefits include competitive wages, health plans, and generous tuition reimbursement.

Qualifications

• Graduate of an accredited nursing program required.
• Current licensure to practice professional nursing in Ohio.
• Minimum of three years acute care nursing experience required.

Responsibilities

• Review patient records for medical necessity and authorization denials.
• Serve as a resource for standards of care in utilization review.
• Develop and enforce compliance policies for regulatory agencies.
• Analyze patient records to determine admission legitimacy.
• Monitor appropriate utilization of resources using clinical criteria.

Skills

Clinical decision-making

Interdisciplinary collaboration

Regulatory compliance

Utilization review knowledge

Education

Bachelor's degree in Nursing (BSN)

Job description

A regional healthcare provider in Bowling Green, Ohio, is seeking an RN for Utilization Review on a per diem basis. This role involves reviewing patient records for medical necessity, collaborating with healthcare teams, and ensuring adherence to clinical guidelines. A Bachelor's degree in Nursing is preferred along with a valid Ohio nursing license and a minimum of three years in acute care. Benefits include competitive wages, health plans, and generous tuition reimbursement.