RN Utilization Review
RN Utilization Review
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.