Utilization Review Nurse — Preauth & Care Coordination

Virginia Gay Hospital, Clinics, Home Health, Nursing & Rehab; Vinton (IA); On-site; USD 60,000 - 70,000; Part time

Benefits offered by this job

Competitive salary

Health, dental, vision, life insurance

Retirement plan with match

Paid time off

License and Continuing Education Reimb

Job summary

Virginia Gay Hospital in Vinton, IA is seeking a Utilization Tech/Nurse to perform preadmission screenings, monitor patient status, and coordinate notifications with third-party payors. The UR Tech/Nurse will also handle precertification of outpatient procedures and medication preauthorization, with chart audits as needed.

The role includes InterQual chart reviews to help determine the appropriate length of stay and level of care.

Qualifications

• Current Iowa nursing license; preferred.
• Prior education/experience as MA/RN/LPN, Utilization Review Nurse, or preauthorization in physician offices.

Responsibilities

• The UR Tech/Nurse is responsible for utilization review of preadmission screenings, monitoring of patient status/needs, and notifying third-party payors; precertification of outpatient procedures and medication preauthorization; auditing charts as requested.
• The UR Tech/Nurse performs InterQual chart reviews to assist with determining the appropriate level and length of stay.

Skills

Utilization Review

Preadmission screening

InterQual review

Education

Iowa nursing license

Job description

Virginia Gay Hospital in Vinton, IA is seeking a Utilization Tech/Nurse to perform preadmission screenings, monitor patient status, and coordinate notifications with third-party payors. The UR Tech/Nurse will also handle precertification of outpatient procedures and medication preauthorization, with chart audits as needed.

The role includes InterQual chart reviews to help determine the appropriate length of stay and level of care.