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UR Nurse or UR Specialist

Newport Healthcare
Remote, USA
Full-time
Entry · 1+ years experience
Remote
USD 37.06-50.72 hourly / hour
Discovered 1 months ago

Full Job Posting

  • Obtain initial behavioral health authorization and complete concurrent reviews.
  • Review the need for denial of stay with assigned clinical treatment team when patient no longer meets acute care criteria.
  • Facilitates appropriate action upon denial.
  • Maintains current level of knowledge on contract requirements of all third-party payor groups.
  • Tracks each patient’s course of treatment through inpatient, residential, partial hospitalization programs and IOP programs.
  • Oriented and educated in gender, cultural differences and in age-appropriate care for Utilization Review.
  • Perform other duties as assigned
  • Requires knowledge of nursing practices, which can be gained only through an accredited school of nursing. Current licensure with the State Board of Nursing is required.
  • Required to be knowledgeable of and follow the Nurse Practice Act
  • Previous 1 year utilization review experience required.
  • Knowledge of UR Standards of Excellence.
  • Display a professional attitude in all aspects of nursing performance.
  • Must be proficient in using Microsoft Office Products including Word and Outlook.

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