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Reading Hospital - Tower Health

West Reading, Pennsylvania

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Michigan Education Special Services Association

East Lansing, Michigan

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Brown & Brown Absence Services Group

USA,

Kaiser Permanente

San Jose, California

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ChristianaCare Health System

Newark, Delaware

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Baylor Scott & White Health

Pflugerville, Texas

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MemorialCare Health System

Fountain Valley, California

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Kindred Healthcare

Los Angeles, California

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Banner Health

Gilbert, Arizona

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Veterans Affairs, Veterans Health Administration

Ann Arbor, Michigan

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Veterans Affairs, Veterans Health Administration

Pittsburgh, Pennsylvania

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Veterans Affairs, Veterans Health Administration

Corpus Christi, Texas

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Baylor Scott & White Health

TEMPLE, Texas

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ChristianaCare

Elkton, Maryland

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Veterans Affairs, Veterans Health Administration

Reno, Nevada

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Kindred Healthcare

Springfield, Missouri

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AdventHealth

Sebring, Florida

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Phoenix Children's Hospital, Provider Recruitment

Phoenix, Arizona

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AdventHealth

Orlando, Florida

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Baylor Scott & White Health

Burnet, Texas

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Veterans Affairs, Veterans Health Administration

Bronx, New York

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Banner Health

Sun City, Arizona

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Veterans Affairs, Veterans Health Administration

Madison, Wisconsin

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Utilization Review RN (remote)
JOB SUMMARYThe Utilization Review Registered Nurse (RN) provides a clinical review of cases using medical necessity criteria to determine the medical appropriateness of inpatient and outpatient services. Provides feedback and assistance to other members of the healthcare team regarding the appropriate use of resources and timely follow-through with the plan of care. Provides ongoing communication with the health plan, provider utilization and/or care coordination departments regarding medical necessity for prospective, concurrent, and retrospective reviews. Collaborates as a team to ensure that medical records support the level of services being delivered.ESSENTI


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