CoxHealth Utilization Review Registered Nurse - Utilization Review
Company: CoxHealth
Location: Springfield
Posted on: August 6, 2022
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Job Description:
Summary Job Summary The Utilization Review Nurse RN collaborates
with the physician and members of the multidisciplinary team to
facilitate progression-of-care; monitors the patient's progress,
intervening appropriately to ensure that the plan of care and
services provided are patient focused, high quality, evidence
based, appropriate to patient needs, efficient, and cost effective.
Conduct concurrent medical record review for medical necessity and
level of care using nationally recognized acute care indicators and
criteria as approved by medical staff, accrediting bodies, and
other state agencies. Prospectively or concurrently determines the
appropriateness of inpatient or observation services following
review of relevant medical documentation, medical guidelines and
insurance benefits and communicates information to payers in
accordance with contractual obligations. Serve as a resource to the
physicians and provide education and information on resource
utilization, national and local coverage determinations, and use of
hospital admission criteria. Job Requirements Education Required:
Graduate of an accredited school of nursing Preferred: Bachelor's
of Nursing with knowledge of InterQual Level of Care Criteria
and/or Milliman Care Guidelines and of local/national coverage
determinations Experience Required: Minimum of 3 years hospital
experience Skills Excellent interpersonal skills, including ability
to be genuine and empathetic Excellent communication (verbal and
written) skills with attention to detail Computer skills Ability to
interact professionally and contribute to the interdisciplinary
team Licensure/Certification/Registration Current RN License in the
state of Missouri Preferred: Certified Case Manager Additional
Information Job Benefits & Perks! Preventive Health Plans available
On-site Daycare with extended hours, holidays and weekends Employee
Discount at CoxHealth Fitness Centers Pharmacy delivery to your
unit On-site Employee Health services Opportunity to earn referral
bonuses of up to $5,000 per hire for certain positions 1906
Employee Store Cafeteria discount If you would like more
information about job benefits & perks, please feel free to email
us @ hr-recruitment@coxhealth.com or visit
https://www.coxhealth.com/employees/benefits/
Keywords: CoxHealth, Springfield , CoxHealth Utilization Review Registered Nurse - Utilization Review, Healthcare , Springfield, Missouri
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