Utilization Review Nurse (Full-Time/ Day Shift)

The Utilization Review Nurse is responsible for conducting admission and continued stay reviews to ensure appropriate utilization of hospital resources and compliance with medical necessity criteria, payer requirements, regulatory standards, and organizational policies. The Utilization Review Nurse works collaboratively with physicians, case managers, revenue cycle staff, and interdisciplinary care teams to facilitate appropriate patient status determinations and optimize reimbursement while supporting quality patient care. This position requires extensive acute care nursing experience and demonstrated expertise in utilization review within a hospital setting. 8, 10 or 12 hour shift options.