Hospital/Acute Utilization Review Nurse - Remote, United States - R.A.M. Healthcare Consulting Group, Inc.

Description

R.A.M.

HCG is seeking a _*Utilization Review Nurse*_ with *CURRENT* experience as a _*Utilization Review Nurse*_ for a 13 week contract The _*Utilization Review Nurse *_will work remotely and will review Intermediate level of care records.

The _*Utilization Review Nurse*_ MUST have experience from a hospital.

The _*Utilization Review Nurse*_ will have 3+ years of experience as a Case Manager, a BSN and have current Utilization Review experience (at least two years).

Required for this _*Utilization Review Nurse *_role:

• Strong understanding of medical terminology, healthcare procedures, and clinical guidelines to effectively evaluate the appropriateness and necessity of healthcare services.
• Excellent analytical and critical thinking skills to assess complex medical cases, identify patterns, and make sound decisions regarding patient care.
• Effective communication skills to liaise with healthcare providers, insurance companies, and patients, ensuring clear and concise exchange of information and facilitating collaborative decision-making processes.
• Proficiency in utilizing software and databases for medical record review, documentation, and data analysis to streamline the utilization review process and maintain accurate records.
• Active RN license in good standing

*Job Duties for the Utilization Review Nurse :

• Analyze medical documentation to evaluate the utilization of healthcare services and assess the medical necessity of treatments and procedures.
• Communicate with healthcare providers, insurers, and patients to gather relevant information and clarify discrepancies in medical records.
• Utilize evidence-based guidelines and industry standards to make informed decisions regarding the approval or denial of healthcare services.
• Collaborate with interdisciplinary teams to develop individualized care plans and ensure that patients receive appropriate and timely interventions.
• Monitor the progress of patients throughout their treatment journey, conducting periodic reviews to reassess the need for ongoing care and adjust plans accordingly.
• Document all findings, decisions, and recommendations accurately and maintain thorough records in compliance with regulatory requirements and organizational policies.

*R.A.M.

HCG consultants receive the following benefits:

• Competitive Pay
• W-2 Employee Status
• Medical Benefits
• 401(k) Employer Match
• FSA and Dependent Care
• Paid Time Off
• Paid Weekly
• Direct Payroll Deposit

R.A.M. Healthcare Consulting Group has over two decades combined experience providing consulting services to hospitals throughout the United States. R.A.M HCG has built a solid reputation providing superior customer service and client satisfaction. With quality, service, and integrity as our core values, we specialize in quality staffing for hospitals nationwide. Our success begins with the right people—a highly trained staff and quality healthcare specialists. We are proud of our consultants and stand by them 100%. We also constantly invest in our staff and provide a great work environment and best-in-class benefits.

We are an equal opportunity employer, dedicated to a policy of nondiscrimination in employment on any basis including race, creed, color, age, sex, religion or national origin.

For more information about this _*Utilization ReviewNurse*_ opening and to be considered, please contact _*Brooke Bridges: *_


Job Type:
Contract


Pay:
$ $40.00 per hour

Expected hours: 40 per week


Benefits:

• 401(k) matching
• Dental insurance
• Flexible spending account
• Health insurance
• Paid time off
• Vision insurance

Healthcare setting:

• Hospital

Schedule:

• 8 hour shift
• Monday to Friday

Education:

• Bachelor's (Required)

Experience:

• Case management: 3 years (Required)
• Utilization review: 2 years (Required)

License/Certification:

• RN License (Required)

Work Location:
Remote