Utilization Review Nurse — Care Coordination Expert

IntelyCare; Quincy (MA); On-site; USD 70,000 - 90,000; Full time

Job summary

Mass Digital Health in Quincy, Massachusetts is seeking a Utilization Review Nurse to evaluate patients for admission appropriateness and coordinate care activities. This role demands collaboration with physicians, care managers, and extensive clinical knowledge to ensure effective patient management.

Ideal candidates should be Registered Nurses with experience in care management or utilization review. Strong communication and negotiation skills are essential as you’ll be guiding patients and families throughout their care journey.

Qualifications

• Minimum two years experience as an RN is preferred.
• Experience in care management and/or utilization management preferred.
• Ability to work independently or within a team structure.

Responsibilities

• Evaluates medical records for appropriateness of admission status.
• Collaborates with physicians and care managers.
• Maintains records in a complete and orderly manner.

Skills

Ability to negotiate

Excellent interpersonal skills

Collaborative teamwork

Clinical knowledge

Education

Registered Nurse with current Alabama license

Job description

Mass Digital Health in Quincy, Massachusetts is seeking a Utilization Review Nurse to evaluate patients for admission appropriateness and coordinate care activities. This role demands collaboration with physicians, care managers, and extensive clinical knowledge to ensure effective patient management.

Ideal candidates should be Registered Nurses with experience in care management or utilization review. Strong communication and negotiation skills are essential as you’ll be guiding patients and families throughout their care journey.