Utilization Tech

Virginia Gay Hospital, LTC and Clinics; Vinton (IA); On-site; USD 54,000 - 74,000; Full time

Benefits offered by this job

Retirement plan with match

Paid time off

License and Continuing Education Reimb

Job summary

Virginia Gay Hospital in Vinton, Iowa seeks a Utilization Review Tech/Nurse to perform preadmission screenings, monitor patient status, notify payors, and precertify outpatient procedures, with chart auditing and InterQual reviews to determine level and length of stay.

Qualified applicants hold a current Iowa nursing license (preferred), BCLS, and UR or physician office preauthorization experience. The organization offers retirement with match, paid time off, and license/CE reimbursement.

Qualifications

• Must have nursing license in Iowa (preferred) and BCLS.
• Experience in utilization review, preauthorization, or physician office UR is a plus.
• Ability to audit charts and apply InterQual criteria.

Responsibilities

• Perform utilization review for preadmission screenings.
• Monitor patient status and needs; notify third-party payors.
• Precertify outpatient procedures; audit charts as requested.
• Apply InterQual review to determine appropriate LOS.

Skills

Utilization review

Preadmission screening

InterQual review

Patient monitoring

Education

Iowa nursing license (preferred)

Tools

InterQual

Job description

Virginia Gay Hospital, established in Vinton in 1923, is an independent, nonprofit critical access hospital supported by a strong local community. The organization includes a 25-bed hospital and four family medical clinics located throughout Benton County, Iowa, offering high-quality, local healthcare and opportunities for professional growth and meaningful patient relationships.

Position Summary

ESSENTIAL DUTIES AND RESPONSIBILITIES

• The Utilization Review Tech/Nurse is responsible for the utilization review for preadmission screenings of patients, monitoring of patient status/needs, and notification of third-party payors, precertification of outpatient procedures, medication preauthorization and auditing charts as requested. The UR Tech/Nurse is responsible for the InterQual review of charts to assist with determination of appropriate level and length of stay.

MINIMUM QUALIFICATIONS (from job description)

• Current Iowa nursing license, preferred. Graduated from a state approved nursing program if applicable. Maintains current BCLS if indicated. Would prefer candidate to have previous education and experience as an MA/RN/LPN, Utilization Review Nurse and/or have experience in physician office preauthorization and utilization review.

• Retirement plan with match
• Paid time off
• License and Continuing Education Reimbursement available.

Equal Opportunity Statement

Virginia Gay Hospital is an equal opportunity employer.