Utilization Review RN

Healthcare Support Staffing; Brentwood (TN); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Competitive salary

Medical, Dental, and Vision benefits

Positive work environment

Weekly deposit options

Job summary

A prestigious healthcare company in Brentwood, TN is seeking an experienced Registered Nurse for the Utilization Review position. You will telephonically review medical information to determine the necessity of continued stay while ensuring compliance with CMS criteria. The role offers a competitive salary and a friendly working environment, along with excellent benefits. Interested candidates with an RN license in TN and at least 2 years of experience in Utilization Management are encouraged to apply.

Qualifications

• RN license in Tennessee is required.
• Must have at least 2 years of experience in Utilization Management.
• Experience in pre-authorization and concurrent review is necessary.

Responsibilities

• Review medical information to determine necessity of continued stay.
• Ensure services are within benefit plan and appropriate providers are utilized.
• Assess and coordinate simple discharge planning.
• Identify and address potential care gaps and utilization issues.

Skills

RN license in the state of TN

Experience in Utilization Management

Strong understanding of discharge planning

CMS criteria knowledge

Nursing background

Education

Bachelor's Degree in related field

Bachelor's degree in related field

Job description

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Description

Are you an experienced Registered Nurse with Utilization Review experience professional looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!

Position Summary:

As the Utilization Review RN, you would be responsible for telephonically reviewing medical information in order to determine medical necessity of continued stay according to review standards.

Hours for this Position: Monday-Friday 8:00am-5:00pm

Advantages of this Opportunity:

• Competitive salary, negotiable based on experience
• Benefits offered, Medical, Dental, and Vision
• Fun and positive work environment
• Weekly deposit options

More Insight of Daily Responsibilities:

• Ensures that services provided to eligible members are within benefit plan and appropriate contracted providers are being utilized
• Determines medical necessity and length of stay based on the consistent application of CMS criteria
• Assesses and coordinates simple discharge planning
• Identifies quality of care issues

Qualifications

What We Look For:

• RN license in the state of TN
• Bachelor's Degree in related field
• 2+ years of experience in UM, UR, pre-authorization, concurrent review, discharge planning and/or skilled nursing

Additional Information

Want More Information?

Interested in hearing more about this great opportunity? Reach out to Amanda Hammer at ahammer @healthcaresupport.com or click apply for additional details.