[Hiring] Utilization Review Nurse or Specialist @Newport Healthcare

Role Description

• Obtain initial behavioral health authorization and complete concurrent reviews.
• Review the need for denial of stay with assigned clinical treatment team when patient no longer meets acute care criteria.
• Facilitates appropriate action upon denial.
• Maintains current level of knowledge on contract requirements of all third-party payor groups.
• Tracks each patient’s course of treatment through inpatient, residential, partial hospitalization programs and IOP programs.
• Oriented and educated in gender, cultural differences and in age-appropriate care for Utilization Review.
• Perform other duties as assigned.

Qualifications

• Requires knowledge of nursing practices, which can be gained only through an accredited school of nursing.
• Current RN licensure with the State Board of Nursing is required.
• Required to be knowledgeable of and follow the Nurse Practice Act.
• Previous 1 year utilization review experience required.
• Knowledge of UR Standards of Excellence.
• Display a professional attitude in all aspects of nursing performance.
• Must be proficient in using Microsoft Office Products including Word and Outlook.

Benefits

• Pay Range for this position based on licensure and experience.
• This position requires working hours in the Central Time Zone.
• Utilization Review Specialist range $25 to $36.50.
• Utilization Review Nurse range $37.06 to $50.72.

Company Description