Utilization Review - Registered Nurse (Weekend)
Full Job Posting
The Utilization Review RN will perform reviews of current inpatient services, and determine medical appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination.
Collaborates with UM Specialists, Physician Advisor, and various departments regarding medical necessity of hospital stays from admission authorizations to discharge, including denials and appeals.
Strong communication skills are necessary to access available resources and communicate with providers and other members of the interdisciplinary team.
Active participation in program development and process improvement efforts is an expectation.
About MOSAIC
Nonprofit healthcare system providing patient-centered care in the Midwest.
Visit company websiteApply for this job in 1 click
Skip the repetitive application forms
Install the Base Career Chrome Extension and autofill job applications across major job boards with your profile.
Trusted by over 500,000 job seekers on Base Career
More from this employer
More jobs at MOSAIC
Maryville Food Service Associate - Utility
Maryville, USA
The Food Service Utility position works under the supervision of leadership to complete cleaning and sanitation duties for all areas of the Nutrition and Dining Services department. They will perform a variety of miscell
Pharmacy Technician III - Inventory Specialist
Saint Joseph, USA
The Pharmacy Technician - Inventory Specialist works under the supervision of the Director of Pharmacy and Pharmacy Strategic Sourcing Manager. The position will manage pharmacy inventory by maintaining pharmaceutical st
Maryville Environmental Services Technician
Maryville, USA
Providing exceptional customer service and patient satisfaction is a responsibility of the EVS Technician-AM, who works under the supervision of the EVS Manager. Provides a daily cleaning of inpatient and non-patient are
Medical Office Assistant (MOA) - Permanent, part time, Burnaby
Burnaby, CAN
INTERNAL APPLICANTS ONLY - Activity Coach, On-call (12 week contract)
Surrey, CAN
RHTP Program Navigator
Maryville, USA
The RHTP Navigator will serve as a frontline, community-based member of a Local Community Hub within Missouri’s Transformation of Rural Community Health Care (ToRCH Care) model. Local Community Hubs are county-level care
CNA/PCA - Surgical and Surgical Step-down
Saint Joseph, USA
The Patient Care Associate works under the supervision of leadership. The Patient Care Associate works under the direction of an RN\LPN or Provider. Administers quality patient care according to established standards. Ma
Maryville Food Service Associate - Utility
Maryville, USA
On-Call ESL Instructor
Burnaby, CAN
Pharmacy Technician III - Inventory Specialist
Saint Joseph, USA
Maryville Environmental Services Technician
Maryville, USA
Medical Office Assistant (MOA) - Permanent, part time, Burnaby
Burnaby, CAN
INTERNAL APPLICANTS ONLY - Activity Coach, On-call (12 week contract)
Surrey, CAN
RHTP Program Navigator
Maryville, USA
CNA/PCA - Surgical and Surgical Step-down
Saint Joseph, USA