Inpatient Utilization Review Nurse (RN)

Position Overview

This role facilitates patient care by determining and reviewing ongoing medical criteria standards and benchmarks. It ensures effective transitions for patients and their families by coordinating patient transitions in accordance with utilization review guidelines and admission criteria through appropriate services. The role involves communicating with clinical and utilization review staff, updating daily patient/family situations, planning for patient discharge with all necessary arrangements, and acting as a liaison between patients/families and healthcare providers. Additionally, the position supports patient/family and staff education while providing extensive clinical support in crises. Available positions: Full-time & PRN. Compensation: $96,033.60 - $157,289.06.

Key Responsibilities

• Facilitate patient care by reviewing ongoing medical criteria standards and benchmarks.
• Ensure effective transitions for patients and their families.
• Coordinate patient transitions in accordance with utilization review guidelines and admission criteria through appropriate services.
• Communicate and consult with clinical and utilization review staff regarding patient progress and movement through the system.
• Update patient and family situations daily.
• Plan for patient discharge by arranging necessary contacts and securing placement prior to discharge.
• Meet with families individually to prepare for discharge.
• Act as a liaison between patients/families and other healthcare providers, agencies, and payers.
• Provide education to patients/families for continuing care options and support staff education.
• Offer extensive clinical support to families in crises.

Required Qualifications

• ADN, BSN, MSN, or CNL from an accredited School of Nursing is required.
• Minimum 2 years of clinical nursing experience; previous utilization review experience required.
• Active MD RN License or Active Compact State RN and Basic Life Support certification for healthcare providers is required.

Benefits & Perks

• Culture – Collaborative, inclusive, diverse, and supportive work environment.
• Career Growth – Career mentoring to help you pursue your passions and enhance your skills.
• Wellbeing – Competitive salary and Total Rewards benefits to help keep you happy and healthy.
• Reputation – Regional and national recognition, advanced technology, and leading medical innovations.