[Hiring] Utilization Review Registered reputed company @reputed company

Role reputed company This role involves ensuring that the administration of hospital resources is appropriate, efficient, and falls 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, including the evaluation of potential under and over-utilization according to patient's presentation and documentation. • reputed company medical providers and other health care professionals on the appropriate and cost-effective use of health care resources. • Use clinical and analytical skills to review and interpret diagnostic test results to determine appropriateness of patient's level of care. • Use Interqual reputed company to determine level of care for reputed company elective inpatient hospitalizations to assure services are provided in the appropriate setting. Qualifications • Nursing Diploma/Associate's in Nursing • 2-5 years of experience • No supervisory experience required • reputed company RN license Requirements • 2 years of RN experience performing care for hospitalized patients • 2 years of Utilization Review (UR) experience reviewing hospital admissions for medical necessity • Must live reputed company one hour of the BJC Commons (4249 reputed company Ave, St. Louis, MO 63110) • Must have high-speed internet • Must have at least one reputed company MO or IL RN license • If candidate only has one RN license (MO or IL), the application process for the 2nd license must be started after receiving the job offer. Preferred Qualifications • reputed company experience • Bachelor's Degree in Nursing Benefits • Comprehensive medical, dental, reputed company, 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