Utilization Review Nurse - Critical Access Hospital

Virginia Gay Hospital, LTC and Clinics; Vinton (IA); On-site; USD 54,000 - 74,000; Full time

Benefits offered by this job

Retirement plan with match

Paid time off

License and Continuing Education Reimb

Job summary

Virginia Gay Hospital in Vinton, Iowa seeks a Utilization Review Tech/Nurse to perform preadmission screenings, monitor patient status, notify payors, and precertify outpatient procedures, with chart auditing and InterQual reviews to determine level and length of stay.

Qualified applicants hold a current Iowa nursing license (preferred), BCLS, and UR or physician office preauthorization experience. The organization offers retirement with match, paid time off, and license/CE reimbursement.

Qualifications

• Must have nursing license in Iowa (preferred) and BCLS.
• Experience in utilization review, preauthorization, or physician office UR is a plus.
• Ability to audit charts and apply InterQual criteria.

Responsibilities

• Perform utilization review for preadmission screenings.
• Monitor patient status and needs; notify third-party payors.
• Precertify outpatient procedures; audit charts as requested.
• Apply InterQual review to determine appropriate LOS.

Skills

Utilization review

Preadmission screening

InterQual review

Patient monitoring

Education

Iowa nursing license (preferred)

Tools

InterQual

Job description

Virginia Gay Hospital in Vinton, Iowa seeks a Utilization Review Tech/Nurse to perform preadmission screenings, monitor patient status, notify payors, and precertify outpatient procedures, with chart auditing and InterQual reviews to determine level and length of stay.

Qualified applicants hold a current Iowa nursing license (preferred), BCLS, and UR or physician office preauthorization experience. The organization offers retirement with match, paid time off, and license/CE reimbursement.