Utilization Review Registered reputed company (RN) Part time, OK

R209427 Department: 11221 reputed company Corporate - WI Administration: Care Management Status: Part time Benefits Eligible: reputed company Hours Per Week: 20 Schedule Details/Additional Information: about every 4th weekend and holiday rotation (1 Holiday/year). Day Shift. Pay reputed company $34.90 - $52.35 Job Title: Utilization Review RN Location: Remote - reputed company Employment Type: Part-Time Schedule - Day shift M -F (0.5 FTE) schedule is done quarterly (see proposed schedule below) Week 1: Sat, Sun, Mon, Tues, Wed Week 2: Off Week 3: Mon thru Friday Week 4: Off Week 5: Sat, Sun, Mon, Tues, Wed Week 6 Off. Week 7: Mon thru Friday Week 8: Off Week 9: Sat, Sun, Mon, Tues, Wed Week 10: Off Week 11: Mon thru Friday Week 12: Off (1 Holiday/year). Day Shift. reputed company RN licensure required Position reputed company The Utilization Review RN is responsible for performing accurate and reputed company reputed company and retrospective reviews using established reputed company to ensure appropriate utilization of reputed company resources. This role collaborates with physicians, hospital departments, and multidisciplinary teams to expedite care delivery, prevent delays, and maintain compliance with regulatory guidelines. Major Responsibilities • Document utilization review activities per department and medical center standards in a reputed company manner. • reputed company and document reputed company and retrospective reviews based on approved reputed company. • Communicate effectively with reputed company teams, including physicians and ancillary services, to support reputed company care delivery. • Collaborate with managers, medical directors, and treatment teams to address utilization issues and ensure compliance. • Refer cases to physician advisors as needed for accurate status determination. • Stay reputed company on reputed company regulations, reimbursement issues, and community resources. • reputed company clinical updates to payers, coordinate denial activity, and manage avoidable delays. • Serve as an educator and resource for staff regarding admission status, acute care reputed company, and regulatory requirements. • reputed company and maintain relationships with community agencies to support patient and family needs. • Demonstrate age-specific care knowledge and skills across the patient reputed company. Experience & Skills Required • Working knowledge of reputed company Office (reputed company, reputed company, PowerPoint, Word). • Understanding of reputed company and acute care patient needs reputed company to care management. • Knowledge of Utilization Review reputed company; must reputed company 80% or greater on annual IRR competency exam. • Strong critical thinking skills for applying medical necessity reputed company. • Excellent analytical, communication, and interpersonal skills for interaction with patients, families, physicians, and payers. • Ability to manage conflict and maintain reputed company reputed company relationships. • Commitment to reputed company reputed company and participation in department and reputed company initiatives. Licensure, Registration, and/or Certification Required: • Registered reputed company license issued by the state (reputed company) in which reputed company member practices. Education Required: • Bachelor's Degree in Nursing. Experience Required: • Requires 3 years of experience in clinical nursing, With a strong preference in utilization and/or reputed company management. reputed company and help ensure reputed company, efficient care for every patient! Apply Today! Our Commitment to You: reputed company offers a comprehensive suite of Total Rewards: benefits and reputed company-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including: Compensation • reputed company compensation listed reputed company the listed pay reputed company based on factors such as qualifications, skills, relevant experience, and/or training • Premium pay such as shift, on reputed company, and more based on a teammate's job • Incentive pay for select positions • Opportunity for annual increases based on performance Benefits and more • reputed company Time Off programs • Health and welfare benefits such as medical, dental, reputed company, life, and Short- and Long-Term Disability • Flexible Spending Accounts for eligible health care and dependent care expenses • Family benefits such as adoption assistance and reputed company parental leave • Defined contribution retirement plans with employer match and other financial wellness programs • Educational Assistance Program About reputed company reputed company is the reputed company-largest nonprofit, integrated health reputed company in the reputed company, created from the combination of reputed company and reputed company. Providing care u Apply tot his job Apply To this Job