What are the responsibilities and job description for the Utilization Review Nurse position at Zodiac Solutions Inc.?
Job Summary
The Utilization Review Nurse plays a crucial role in ensuring that patients receive appropriate and efficient healthcare services. This position involves reviewing clinical documentation to assess the necessity, appropriateness, and efficiency of healthcare services provided to patients. The ideal candidate will possess a strong background in nursing, health information management, and medical coding, with a focus on improving clinical documentation and medical management processes.
Responsibilities
- Conduct thorough reviews of clinical documentation to ensure compliance with established standards and guidelines.
- Assess the necessity and appropriateness of healthcare services provided in various settings, including home care and nursing homes.
- Collaborate with healthcare providers to facilitate effective communication regarding patient care needs and service utilization.
- Identify opportunities for clinical documentation improvement and provide recommendations for enhancements.
- Maintain accurate records of utilization review activities and prepare reports as required.
- Stay updated on relevant regulations, policies, and best practices in medical management and utilization review.
- Participate in quality improvement initiatives aimed at enhancing patient outcomes and operational efficiency.
Job Type: Contract
Pay: $50.00 - $60.00 per hour
Work Location: In person
Salary : $50 - $60
