Overview:
The Utilization Review team is comprised of highly skilled Registered Nurses who ensure Norman Regional Health System follows a compliant review process to determine appropriateness of admission.
Responsibilities:
Job Summary
- Utilization Review, Utilization Management, Advocacy and Education
- Clinical Analysis and Data Management
- Clinical Care Management/Coordination
- Resource Management
- Transition Management and Denial Prevention
- Utilization Management
- Psychosocial Management
- Assist with establishing and review of departmental metrics on annual basis or as needed to insure mission, vision and strategic plan of NRHS.
Qualifications
Prior Utilization Review experience preferred. Current knowledge of medical necessity guidelines for hospitalization status preferred.
Education
Diploma or Associate’s degree (ADN) required, Bachelor of Science in Nursing (BSN), or Masters of Science in Nursing (MSN) preferred.
Experience
3 years of acute RN experience required.
Licensure/Certification/Registration/ETC.
Current, RN license in the state of Oklahoma, Basic Life Support (BLS) training or retraining is required and must be maintained for the duration of employment.
Qualifications:
Diploma or Associate’s degree (ADN) required, Bachelor of Science in Nursing (BSN), or Master's of Science in Nursing (MSN) preferred.
Current, RN license in the state of Oklahoma, Basic Life Support (BLS) training or retraining is required and must be maintained for the duration of employment.
3 years of acute RN experience required.
Prior Utilization Review experience preferred. Current knowledge of medical necessity guidelines for hospitalization status preferred.
