Utilization Review Registered Nurse

Health eCareers; St. Louis (MO); Remote; USD 80,000 - 100,000; Part time

Job summary

A leading healthcare organization is seeking a Utilization Review Registered Nurse for a part-time, remote position. The role involves evaluating medical necessity and educating providers on resource use while ensuring efficient hospital resource administration. Candidates must have RN licenses in Missouri and Illinois, with a preference for those with EPIC experience.

Benefits

Comprehensive benefits including medical, dental, vision, life insurance

401(k) with match

Tuition assistance

Qualifications

• 2 years of RN experience providing care for hospitalized patients.
• 2 years of Utilization Review experience reviewing hospital admissions.

Responsibilities

• Review diagnostic test results to determine appropriateness of patient's level of care.
• Use Interqual Criteria to determine level of care for inpatient hospitalizations.

Skills

Utilization Review

Patient Care

Education

Nursing Diploma/Associate's

Tools

EPIC

Job description

Join to apply for the Utilization Review Registered Nurse role at Health eCareers

Join a stable work-from-home team! This is a great opportunity for a local remote position. There is no communication with patients. This position supports all units/staff (commercial, behavioral health, inpatient, etc.)

Requirements

• 2 years of RN experience providing care for hospitalized patients
• 2 years of Utilization Review experience reviewing hospital admissions for medical necessity
• Must live within one hour of the BJC Learning Institute (8300 Eager Road - Brentwood, MO 63144)
• Have both Missouri and Illinois RN licenses (if a candidate only has one license, the application process for the 2nd license can be started after receiving the job offer.)
• Benefits eligible
• Monday - Friday; days; three shifts per week
• Part-time; 24 hours per week
• 8:00am-4:30pm
• One Sunday shift every 4-6 weeks

Preferred Requirements

• EPIC experience is a plus!

Overview

BJC HealthCare is one of the largest nonprofit health care organizations in the United States, serving the greater St. Louis, southern Illinois, and southeast Missouri regions. It operates 14 hospitals and multiple community health locations, providing inpatient and outpatient care, primary care, community health, and more.

Role Purpose

Ensure appropriate, efficient hospital resource administration within patient payment structures while providing safe, quality care. Evaluate medical necessity and educate providers on cost-effective resource use.

Responsibilities

• Review diagnostic test results to determine appropriateness of patient's level of care.
• Use Interqual Criteria to determine level of care for inpatient hospitalizations.

Minimum Requirements

• Education: Nursing Diploma/Associate's
• Experience: 2-5 years
• Licenses & Certifications: RN

Benefits And Legal Statement

• Comprehensive benefits including medical, dental, vision, life insurance, legal services, disability insurance, pension, 401(k) with match, tuition assistance, and more.

Compensation: $32.80 - $50.39 per hour