RN Utilization Review Specialist — Inpatient Care Impact

Jacksonville Memorial Hospital; United States; Presencial; USD 4.948.000 - 7.917.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Paid time off

401(k) match

Health/dental/vision insurance

Descripción de la vacante

Memorial Health seeks a Registered Nurse for Utilization Review to conduct concurrent and retrospective reviews of inpatient medical records, ensuring accurate documentation and appropriate utilization of acute care services. The role emphasizes collaboration with the care team and adherence to reimbursement principles.

Responsibilities include determining admission status, performing continued stay reviews, and certifying level of care.

Formación

• Education: Associate Degree in Nursing; Bachelor’s Degree in Nursing preferred.
• Licensure/Certification/Registry: Current RN licensure in the State of Illinois.
• Experience: 3–5 years of acute care and/or home health nursing or case management; utilization review experience preferred.
• Knowledge/Skills: Understanding of healthcare reimbursement; strong communication; adaptability and problem solving.

Responsabilidades

• Provide concurrent and retrospective review of inpatient medical records to evaluate documentation and utilization of acute care services.
• Facilitate physician documentation to accurately reflect severity of illness and risk of mortality.
• Perform utilization review of patients for admission to inpatient, observation, or other status; conduct continued stay reviews.
• Collaborate with health care team to certify level of care.

Conocimientos

Communication skills

Problem solving

Adaptability

Educación

Associate’s Degree in Nursing

Bachelor’s Degree in Nursing preferred

Descripción del empleo

Memorial Health seeks a Registered Nurse for Utilization Review to conduct concurrent and retrospective reviews of inpatient medical records, ensuring accurate documentation and appropriate utilization of acute care services. The role emphasizes collaboration with the care team and adherence to reimbursement principles.

Responsibilities include determining admission status, performing continued stay reviews, and certifying level of care.