Utilization Review RN - Nights

Overview:

The Utilization Review team is comprised of highly skilled Registered Nurses who ensure Norman Regional Health System follows a compliant review process to determine appropriateness of admission.

Responsibilities:

• Utilization Review, Utilization Management, Advocacy and Education
• Clinical Analysis and Data Management
• Clinical Care Management/Coordination
• Resource Management
• Transition Management and Denial Prevention
• Utilization Management
• Psychosocial Management
• Assist with establishing and review of departmental metrics on annual basis or as needed to insure mission, vision and strategic plan of NRHS.

Qualifications:

Education

• Diploma or Associate’s degree (ADN) required, Bachelor of Science in Nursing (BSN), or Master's of Science in Nursing (MSN) preferred.

Experience

• 3 years of acute RN experience required.
• Prior Utilization Review experience preferred.
• Current knowledge of medical necessity guidelines for hospitalization status preferred.

(Above requirements can be met by equivalent combination of education and experience)

Licensure/Certification

• Current, RN license in the state of Oklahoma, Basic Life Support (BLS) training or retraining is required and must be maintained for the duration of employment.

Compensation/Benefits

• $17.39-$28.40/hr depending on previous work experience.
• Benefits include medical, dental, vision, short-term disability, long-term disability, life insurance, paid time off (PTO), paid holidays, tuition reimbursement, scholarship opportunities, retirement plans, free parking, and opportunities for advancement.

Utilization Review RN - Nights at Norman Regional Health System summary:

The Utilization Review RN at Norman Regional Health System conducts compliant reviews to assess the necessity of patient admissions, ensuring clinical efficiency and resource management. The role requires a deep knowledge of medical guidelines and a solid background in nursing, with responsibilities spanning clinical analysis, care coordination, and denial prevention. Ideal candidates possess an ADN or higher and have significant experience in acute care settings, with a focus on utilization management and patient advocacy.

Keywords:

Utilization Review, Registered Nurse, Healthcare Management, Patient Advocacy, Clinical Analysis, Resource Management, Acute Care, Nursing, Utilization Management, Denial Prevention

Location: Nichols Hills, OK, US

Posted Date: 11/29/2024