Job Information

RN Utilization Review

RN Utilization Review

Division

Healthcare Management

Employment Type

Staff

Location

Anchorage, Alaska


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Job Description:

A coastal community in Alaska is seeking a Permanent RN of Utilization Review to work with their Chief Compliance Officer to review daily Inpatient and Swing Bed admissions and other health services to ensure quality and cost-efficiency.   This facility prefers candidates with prior experience working with tribal communities and underserved populations. Amazing benefits are offered, in addition to relocation assistance.

 

Responsibilities of the Utilization Review Registered Nurse:

  • Must work closely with providers, nurses, physicians, family members, and insurance companies while completing timely reviews of all Inpatient and Swing Bed admissions.
  • Follows protocols to determine whether patients meet standards for insurance reimbursement.
  • Must consult on questions of hospital admissions, length of stay, and imaging studies.
  • Develops and implements state-wide programs, policies, and procedures to ensure compliance.
  • Educates providers in the use of appropriate documentation and associated rules and regulations.
  • Completes utilization review projects assigned by the COO.
  • Maintains timely Tumor Registry.
  • Recognizes and resolves documentation and billing problems to reduce delays in patient services and related billing and collections.

Minimum Requirements of the Utilization Review RN:

  • Must be an RN.
  • Must have a Bachelor's Degree.
  • Preferred BSN and CPHQ
  • Must have at least 4 years of hospital experience and one year at least of experience in utilization review.

Benefits:

30+ PTO days for First-Year Employees

No State Income Taxes

No Employee Contribution for Health, Dental, and Vision

Relocation Assistance Provided

Temporary Housing Options

Retirement Plan is in the top 75% of the Nation

 

All interested candidates should submit a copy of their resume.

 

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