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Utilization Review Nurse

Company

Granville Health System

Location

Oxford, United States

Type

Full-time

Position Summary: Conducts patient reviews as specified in review plan using screening criteria; identifies and documents actual and potential delays in services or treatment and works with departments and other providers to resolve problems; communicates to attending physician need for documentation for admission or continuation of hospitalization; refers cases that do not meet criteria to Director when needed. Screens all cases against high risk screens for discharge planning; conduct concurrent and retrospective reviews. Qualifications: North Carolina License as a Registered Nurse. Three years clinical nursing experience. One year utilization and review experience. Experience with MCG authorization criteria preferred. Knowledge of current nursing principles, techniques, procedures; knowledge of current utilization management criteria and standards.#Excellent communication skills. Ability to work with physicians and hospital staff. Maintains professional knowledge and skills related ...

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