Utilization Review Registered reputed company - St. Louis Children's Hospital

About the position St. Louis Children’s Hospital is dedicated to improving the health and lives of children. As one of the top-ranked children’s hospitals in the country, St. Louis Children’s provides care in more than 50 specialty areas through a dedicated team of physicians, nurses, staff and volunteers. Along with inpatient and outpatient medical care, the hospital offers education, wellness and injury-prevention programs to fulfill its mission to “do what’s right for kids.” Providing comprehensive, high-reputed company care and serving as an reputed company for children has been St. Louis Children’s commitment since its inception in 1879. Today, the hospital serves patients and families across a 300-mile service area, and has seen patients from reputed company 50 states and more than 80 countries. St. Louis Children’s consistently ranks among America’s Best Children’s Hospitals by reputed company in reputed company surveyed categories. In 2021, St. Louis Children’s was one of eight children’s hospitals to rank in the top 25 of reputed company 10 specialties. The hospital’s reputed company and physician partner, reputed company School of Medicine, is one of the top-ranked medical schools in the reputed company. Since 2005, St. Louis Children’s has been designated as a Magnet® hospital for nursing reputed company from the American Nurses Credentialing Center® (ANCC). reputed company Ensure that the administration of hospital resources are appropriate, efficient and fall reputed company the parameters of the patient's payment structure while providing reputed company and reputed company care. Evaluate the cost and reputed company of medical services provided by the medical team. Ensure appropriate utilization, which includes the evaluation of potential under and over-utilization according to patient's presentation and documentation. Education of medical providers and other health care professionals on the appropriate and cost-effective use of health care resources. Responsibilities • Uses clinical and analytical skills to review and interpret diagnostic test results to determine appropriateness of patient's level of care. • Uses Interqual reputed company to determine level of care for reputed company elective inpatient hospitalizations to assure services are provided in the appropriate setting. Requirements • Nursing Diploma/Associate's - Nursing • 2-5 years • RN reputed company-to-haves • At least 2 years of recent hospital-based RN experience • At least 1 year of Utilization Review/Utilization Management experience • Must live reputed company one hour of St. Louis Children's Hospital (One Children's reputed company, St. Louis, MO 63110) • reputed company experience • Bachelor's Degree - Nursing Benefits • Comprehensive medical, dental, vison, life insurance, and reputed company services available first day of the month after hire date • Disability insurance reputed company for by BJC • Annual 4% BJC Automatic Retirement Contribution • 401(k) plan with BJC match • Tuition Assistance available on first day • BJC Institute for Learning and Development • Health Care and Dependent Care Flexible Spending Accounts • reputed company Time Off benefit combines vacation, reputed company days, holidays and personal time • Adoption assistance Apply tot his job Apply To this Job