Utilization Review RN: Ensure Quality, Efficient Care

Marion County Public Health Department; Indianapolis (IN); On-site; USD 75,000 - 95,000; Full time

Job summary

Eskenazi Health in Indianapolis seeks an experienced Utilization Review Nurse to maximize quality and cost efficiency of health care services. You will review admissions for medical necessity, coordinate care plans, and collaborate with inpatient teams to ensure appropriate levels of care across the continuum.

The role focuses on utilization management, patient advocacy, and ensuring compliant, timely reviews within the hospital setting.

Qualifications

• Minimum 4 years clinical nursing experience required.
• Knowledge of utilization management processes and criteria.

Responsibilities

• Maximize quality and cost efficiency of health care services through reviews and audits.
• Assess medical necessity of admissions and continued stay.
• Coordinate transition plans and activates with inpatient and outpatient teams.
• Serve as a patient advocate ensuring appropriate care and resources.
• Collaborate with Emergency Physicians, Attending Physicians and Payor Specialists.

Skills

Utilization Management

Nursing

Interpersonal skills

Negotiation

Professionalism

Job description

Eskenazi Health in Indianapolis seeks an experienced Utilization Review Nurse to maximize quality and cost efficiency of health care services. You will review admissions for medical necessity, coordinate care plans, and collaborate with inpatient teams to ensure appropriate levels of care across the continuum.

The role focuses on utilization management, patient advocacy, and ensuring compliant, timely reviews within the hospital setting.