Utilization Review Nurse RN: Optimize Care & Resources

Eskenazi Health; Indianapolis (IN); On-site; USD 65,000 - 95,000; Full time

Job summary

Eskenazi Health is seeking an Utilization Review Nurse to maximize quality and cost efficiency of health care services. The role reviews admissions and continued stay for medical necessity, analyzes records to ensure reimbursement compliance, and collaborates with care teams to coordinate patient transitions.

Current Indiana nursing license and a minimum of 4 years of clinical nursing experience are required. Excellence in communication and advocacy for efficient care are essential.

Qualifications

• Current Indiana nursing license is required.
• Minimum of 4 years of clinical nursing experience.
• Strong interpersonal and written communication skills.

Responsibilities

• Maximize quality and cost efficiency of patient care through utilization review.
• Review medical necessity of admissions and continued stay per policy.
• Collaborate with inpatient and outpatient teams to coordinate transitions of care.
• Apply clinical criteria to determine appropriate level of care within 24–48 hours.

Skills

Nursing

Education

Indiana nursing license

Job description

Eskenazi Health is seeking an Utilization Review Nurse to maximize quality and cost efficiency of health care services. The role reviews admissions and continued stay for medical necessity, analyzes records to ensure reimbursement compliance, and collaborates with care teams to coordinate patient transitions.

Current Indiana nursing license and a minimum of 4 years of clinical nursing experience are required. Excellence in communication and advocacy for efficient care are essential.