Registered Nurse Utilization Review
Location: Baltimore Maryland
Description: Pathway Medical Staffing is employing Registered Nurse Utilization Review right now, this job will be placed in Maryland. More details about this job opportunity kindly read the description below. Provides professional assessment, coordination, and utilization review in accordance with all state mandated regulations. Functions as an advocate and contact person for the patient with ! the insurance company and outside agencies to assure continuity of care and optimal clinical and resource outcomes.
Work schedule will be Monday-Friday day shift 8:00AM to 5:30PM
Analyzes patient records, and participates in interdisciplinary collaboration with professional staff within designated timeframes to determine suitability of the level of care in accordance with approved Intensity of Service and Severity of Illness ( IS/SI) and/ or other established criteria
Performs continuing review on patients’ medical records to ensure appropriate cost efficient healthcare services to patients and their need of on-going hospitalization
Conduct reviews and validates physician’s orders, medical reports and communicates the progress and unusual occurrences on patients to UR Supervisor and/or Hospitalist/Attending Physician
Documents utilization review information in appropriate computer system and communicates results with claim adjusters
E! nters billing information for services
Receives and proces! ses requests for appeal of denials
Maintains Utility review and appeal logs as needed
Advises physicians and other departments of regulations affecting utilization managemen
Consults with the Care Management nurses regarding the discharge plans
Requirements
Please be advised that we are only considering nurses with the following:
Must by a licensed Registered Nurse in the state of Maryland
Must have 2+ years of clinical experience
Must have previous experience with utilization review
Previous experience in utilization review using 2012 or 2013 Interqual guidelines required
Comprehensive benefits for temporary employees include:
Medical/Dental/Vision
Life Insurance/Disability
401(k)
How Pathway Medical Works with You to Get the Job:
Since 1998 we have focused exclusively on helping nurse case managers and related non-bedside nursing professionals find career opportunities that ! fit their lifestyle and advance their careers.
We have long-standing relationships with nurse executives at dozens of leading healthcare organizations, ensuring that your accomplishments and skills get noticed by key decision makers .
We will review your resume to make certain it emphasizes the important skills and experience requirements of the job for which you are applying.
We will then prepare you for your interview , enabling you to show why you are the best candidate for the job.
When an offer is extended we will help you negotiate compensation , benefits and any additional employment issues.
- .
If you were eligible to this job, please email us your resume, with salary requirements and a resume to Pathway Medical Staffing.
If you interested on this job just click on the Apply button, you will be redirected to the official website
This job starts available on: Thu, 27 Jun 2013 20:21:23 GMT