UR Nurse, UR Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Secure initial behavioral health authorization and conduct ongoing reviews.

• Assess the necessity for denial of stay with the designated clinical treatment team when a patient no longer fulfills acute care criteria.

• Initiate appropriate actions following a denial.

• Keep up-to-date with contract stipulations for all third-party payer organizations.

• Monitor each patient's journey through inpatient, residential, partial hospitalization, and IOP programs.

• Utilize knowledge of gender, cultural diversity, and age-appropriate care in the Utilization Review process.

• Carry out additional responsibilities as assigned.

⛳️ Requirements

• Understanding of nursing practices acquired through an accredited nursing program.

• Valid RN licensure from the State Board of Nursing.

• Familiarity with and adherence to the Nurse Practice Act.

• Minimum of 1 year of experience in utilization review.

• Knowledge of UR Standards of Excellence.

• Professional demeanor in all areas of nursing performance.

• Proficient in using Microsoft Office applications, including Word and Outlook.

• Capability to work hours aligned with the Central Time Zone.

🏝️ Benefits

• Comprehensive health insurance options.

• Retirement savings plan with employer matching.

• Paid time off and holidays.

• Opportunities for professional development and training.