Utilization Review Nurse: Drive Quality & Efficient Care

Macon Community Hospital; Lafayette (TN); On-site; USD 30,000 - 59,000; Full time

Job summary

Macon Community Hospital in Lafayette, Tennessee, seeks a Utilization Review Nurse to work within the Care Management department. The role evaluates admissions, treatment, length of stay, and the use of hospital services to support cost-effective, quality patient care.

You will collaborate with interdisciplinary teams, assist with discharge planning, and help develop clinical pathways while ensuring compliance with HIPAA and InterQual criteria; RN licensure in Tennessee is required, BSN

Qualifications

• Current registered nursing license in the State of Tennessee.
• BSN preferred
• Graduate from accredited school of nursing and knowledge of Interqual criteria.

Responsibilities

• Evaluates the appropriateness of hospital admissions and length of stay using established criteria and guidelines.
• Analyzes utilization of hospital services to support quality patient care and cost effectiveness.
• Assists with discharge planning and coordination to ensure continuity of care.
• Participates in performance improvement activities and peer review coordination.

Skills

Communication skills

Team collaboration

Independent work

Education

Registered nursing license in Tennessee

BSN preferred

Job description

Macon Community Hospital in Lafayette, Tennessee, seeks a Utilization Review Nurse to work within the Care Management department. The role evaluates admissions, treatment, length of stay, and the use of hospital services to support cost-effective, quality patient care.

You will collaborate with interdisciplinary teams, assist with discharge planning, and help develop clinical pathways while ensuring compliance with HIPAA and InterQual criteria; RN licensure in Tennessee is required, BSN