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Job summary
A leading healthcare provider in California is looking for a Utilization Review Nurse II to handle discharge planning and utilization reviews. The ideal candidate will have a valid RN license in California and substantial experience in acute care nursing or case management. Responsibilities include evaluating medical records, coordinating with multiple services, and ensuring adherence to documentation requirements. This position is essential for optimizing resource use within the hospital and maximizing reimbursement from payors.
Qualifications
Two years of experience in acute care hospital as a registered nurse.
One year of utilization review/discharge planning experience in acute care.
Five years as a Case Manager in alternate medical settings preferred.
Responsibilities
Evaluate medical records for inpatient admissions.
Coordinate discharge plans and ensure hospital resources are used efficiently.
Teach documentation requirements for reimbursement.
Skills
Utilization review
Care coordination
Medical record evaluation
Communication skills
Data analysis
Education
Valid Registered Nurse license in California
Job description
A leading healthcare provider in California is looking for a Utilization Review Nurse II to handle discharge planning and utilization reviews. The ideal candidate will have a valid RN license in California and substantial experience in acute care nursing or case management. Responsibilities include evaluating medical records, coordinating with multiple services, and ensuring adherence to documentation requirements. This position is essential for optimizing resource use within the hospital and maximizing reimbursement from payors.