Utilization Review Nurse
Decatur, IL, United States
Job Description
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Posted 46 days ago
Tracking Code 2024-20026
Position Summary
Full-Time
Day Shift
This position reviews services to patients of all ages to ensure appropriate status of admission, length of stay and utilization of criteria based Severity of Illness/Intensity of Service. Utilizes clinical and nursing knowledge of documentation requirements to improve overall quality and completeness of clinical documentation of patient records.
Highlights & Benefits
- Paid Time Off (PTO)
- Memorial Childcare
- Mental Health Services
- Growth Opportunities
- Continuing Education
- Local and National Discounts
- Pet Insurance
- Medical, Dental, Vision
- Flexible Spending Account
- 401(k)
- Life Insurance and Voluntary Benefits
- Employee Assistance Program and Colleague Wellness
- Adoption Assistance
Required Skills
- Performs admission, concurrent, and focused reviews using InterQual criteria and CMS regulations.
- Maintains appropriate documentation of reviews.
- Refers medical records to physician advisors for secondary reviews.
- Follows up with admitting providers to discuss status orders as necessary.
- Performs telephone reviews as requested to obtain pre-certification and continued stay certification with private carriers and/or review firms.
- Participates in unit patient care rounds when possible.
- Serves as a resource person to physicians and hospital staff in the appropriate use of health care resources.
- Accepts on-call as scheduled and responds as needed.
- Takes responsibility for upgrading professional skills and knowledge.
- Prepares and completes reports; participates in special projects.
- Performs other duties as assigned.
Required Experience
Nurse with current Illinois RN or LPN license. Five years experience in clinical nursing or discharge planning is required
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Job Detail
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Job IdJD4383762
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IndustryNot mentioned
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Total Positions1
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Job Type:Full Time
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Salary:Not mentioned
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Employment StatusPermanent
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Job LocationDecatur, IL, United States
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EducationNot mentioned