Utilization Review RN (FT, Days)

Education: Graduate of an accredited school of nursing.

Licensure/Certification: Must be licensed to practice as a Registered Nurse in the state of Indiana. Must be current in BLS.

Experience: Two years of hospital clinical experience. Knowledge of medical standards of care, state and federal utilization review laws, and healthcare regulations. Preferred: Prior experience in utilization review, case management, discharge planning, prospective payment systems (DRGs), or the CMS Medicare Swing Bed Program.

Mental/Physical Effort: Work 90% of the time in an office setting and 10% reviewing charts or meeting with staff. Handle frequent interruptions, variable workflows, and confidential information in volatile situations. Use computers, electronic medical records (EMR), spreadsheets, word processing, and email software. Apply critical thinking, decisive judgment, time management, and basic math skills. Read, write legibly, speak clearly, follow instructions, and handle inquiries or complaints professionally.