**Job Summary:** We are currently looking for a dedicated Utilization Review Nurse to join our healthcare team. As a Utilization Review Nurse, you will play a crucial role in ensuring the efficient and effective use of medical services for our patients. This position offers a rewarding opportunity to contribute to medical management and improve patient outcomes through utilization review processes. **Duties:** - Conduct utilization reviews to evaluate the necessity, appropriateness, and efficiency of medical services provided. - Collaborate with doctors, nurses, and other healthcare professionals to optimize inpatient care and hospice services. - Utilize HEDIS measures and Athenahealth software to assess and improve healthcare quality. - Implement clinical documentation improvement strategies to enhance patient care documentation accuracy. - Evaluate emergency medicine cases and critical care services for proper utilization. **Qualifications:** - Bachelor's degree in Nursing or related field; RN license required. - Proven experience in medical management, utilization review, or related healthcare roles. - Familiarity with inpatient care, hospice care, and utilization review processes. - Knowledge of HEDIS standards, Athenahealth software, and clinical documentation improvement practices. - Experience in emergency medicine or critical care settings is a plus. Join our team of healthcare professionals dedicated to optimizing medical services and improving patient care outcomes. If you are a detail-oriented nurse with a passion for medical management and utilization review, we invite you to apply for this challenging yet rewarding position as a Utilization Review Nurse.

Job Types: Full-time, Contract

Pay: $2,200.00 - $2,350.00 per week

Healthcare setting:

• Hospital

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• RN: 2 years (Preferred)
• Utilization management: 2 years (Preferred)

License/Certification:

• BLS Certification (Preferred)

Work Location: In person