Utilization Review RN PRN — Acute Care Expert

Brundage Group; Town of Florida (NY); Hybrid; USD 83,000 - 124,000; Part time

Job summary

Brundage Group seeks a Utilization Review Nurse (PRN/Day Shift) to perform admission and continued stay reviews in a hospital setting. You will apply InterQual/MCG criteria, collaborate with physicians and case managers, and support compliance and appropriate reimbursement.

The role requires RN licensure, BSN preferred, and at least five years of acute care nursing with two years in utilization review. PRN schedule includes 40 hours/month with weekend shifts and 4-8 hour options.

Qualifications

• Graduate of an accredited school of nursing.
• Current, unrestricted RN license.
• BSN preferred; inpatient/acute care experience advantageous.
• Experience in utilization review is preferred.

Responsibilities

• Perform hospital admission reviews to determine medical necessity and patient status.
• Conduct continued stay reviews using clinical criteria (InterQual/MCG).
• Evaluate documentation for accuracy and regulatory compliance.
• Communicate findings to physicians and case management staff.
• Collaborate with Physician Advisors on complex cases.
• Assist with denial prevention and accurate documentation.
• Proficient in multiple EHR and case management systems.
• Must work PRN with minimum 40 hours/month, weekend shifts required.

Skills

Communication skills

Independent worker

Adaptable to pace

Documentation accuracy

Education

RN license

BSN preferred

Accredited nursing program

Job description

Brundage Group seeks a Utilization Review Nurse (PRN/Day Shift) to perform admission and continued stay reviews in a hospital setting. You will apply InterQual/MCG criteria, collaborate with physicians and case managers, and support compliance and appropriate reimbursement.

The role requires RN licensure, BSN preferred, and at least five years of acute care nursing with two years in utilization review. PRN schedule includes 40 hours/month with weekend shifts and 4-8 hour options.