Utilization Review Nurse | Flexible Time Off & Growth

Rising Medical Solutions, LLC; Oregon; Hybrid; USD 70,000 - 100,000; Full time

Benefits offered by this job

Generous Flexible Time Off

Health Insurance

Dental Insurance

Vision Insurance

Profit Sharing

401k Matching

Career Growth Opportunities

Professional Development Reimbursement

Job summary

Rising Medical Solutions is seeking a Utilization Review Nurse in Oregon. This is a full-time, 40-hour week role (M-F) focusing on UR processes, reviewing records and applying evidence-based guidelines to determine authorization.

You will write nurse summaries, document in our databases, coordinate with clients and providers, and maintain files while meeting turnaround times. A nursing degree and active RN license in one or more states are required.

Qualifications

• RN license in one or more states
• 3–5 years clinical practice or 2 years in case management/UR
• Experience with Workers' Compensation, disability, or liability claims
• Strong time-management and organizational skills
• Proficient in MS Word, Excel, and Outlook, with data documentation ability

Responsibilities

• Perform all aspects of the Utilization Review Process
• Review UR records via mail, email, fax, or phone
• Apply evidence-based guidelines to determine authorization
• Write nurse summaries on UR files
• Document in Rising's database and client systems; send determinations
• Collaborate with clients, patients, employers, providers and attorneys
• Track UR activity to meet turnaround times
• Maintain organized file documentation
• Demonstrate clinical judgment and communication skills
• Respond to inquiries about case status
• Be proficient with computers and multitasking

Skills

Clinical judgment

Time management

Communication

Data analysis

Attention to detail

Team player

Education

Associate's or Bachelor's degree in Nursing

Tools

Microsoft Word

Excel

Outlook

Job description

Rising Medical Solutions is seeking a Utilization Review Nurse in Oregon. This is a full-time, 40-hour week role (M-F) focusing on UR processes, reviewing records and applying evidence-based guidelines to determine authorization.

You will write nurse summaries, document in our databases, coordinate with clients and providers, and maintain files while meeting turnaround times. A nursing degree and active RN license in one or more states are required.