Hybrid Utilization Review RN – *Premium Pay* Full-time Weekends

✨ About The Role

- The role involves conducting utilization review services, including prior authorization for inpatient and outpatient reviews, and ensuring treatment setting appropriateness - Responsibilities include reviewing for compliance with applicable criteria and regulatory requirements, as well as communicating clinical information effectively - The position requires working closely with patients, families, and the medical team to provide resources and prevent hospital readmissions - Customizing care plans for patients, which may involve coordinating home health, long-term care placement, and community resources - The job offers a hybrid work opportunity with work-from-home options and requires onsite work on specific days for integrated care management duties

⚡ Requirements

- Experienced RN with a minimum of 3 years of acute care experience, preferably with care management experience - Strong communication skills, both verbal and written, are essential for effective patient interaction and team collaboration - Critical thinking skills are crucial for conducting utilization review services and ensuring compliance with regulatory requirements - Proficiency with basic computer skills is necessary for documenting and communicating pertinent clinical information - Ability to work in a fast-paced environment, prioritize tasks, and customize care plans for patients