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:
- 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:
Education
- Diploma or Associate’s degree (ADN) required, Bachelor of Science in Nursing (BSN), or Master's of Science in Nursing (MSN) preferred.
Experience
- 3 years of acute RN experience required.
- Prior Utilization Review experience preferred.
- Current knowledge of medical necessity guidelines for hospitalization status preferred.
(Above requirements can be met by equivalent combination of education and experience)
Licensure/Certification
- 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.
Compensation/Benefits
- $17.39-$28.40/hr depending on previous work experience.
- Benefits include medical, dental, vision, short-term disability, long-term disability, life insurance, paid time off (PTO), paid holidays, tuition reimbursement, scholarship opportunities, retirement plans, free parking, and opportunities for advancement.
Utilization Review RN - Nights at Norman Regional Health System summary:
The Utilization Review RN is responsible for overseeing the process of determining the appropriateness of admissions at Norman Regional Health System. With a focus on utilization management, clinical analysis, and resource management, they play a vital role in ensuring compliance with medical necessity guidelines and promoting efficient care coordination. The position requires an active RN license and a combination of clinical experience.
Keywords:
Utilization Review, Registered Nurse, Healthcare, Nursing, Clinical Care Management, Resource Management, Acute Care, Admission Review, Healthcare Compliance, Patient Advocacy
