Utilization Review Nurse - Oregon
2 days ago

Job summary
ICM is hiring a Utilization Review Nurse to support our Utilization Review team by evaluating medical necessity requests and reviewing ongoing hospital stays.Responsibilities
- Review precertification requests and determine medical necessity using evidence-based guidelines and plan-specific criteria
- Evaluate clinical documentation for inpatient stays and make length-of-stay extension determinations when appropriate
- Identify gaps in clinical information and communicate clearly with providers to obtain what's needed to support timely decisions
- Select other responsibilities from the job description.
Job description
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