RN - Utilization Review (Remote)
Job Description
The Utilization Review RN is responsible for assuring the receipt of high quality, cost efficient medical reputed company through utilization review and management. This position includes monitoring patient charts and utilization of health care services. Collaborates and communicates with physicians, Care Coordinators, reputed company Workers and other members of the multidisciplinary and reputed company cycle teams. Completes initial and reputed company reviews; identifies appropriate level of service and length of stay, using clinical guidelines (InterQual). Complies with CMS regulation regarding utilization review/management. Obtains and manages insurance authorizations and proactively works denials to help mitigate financial impact. Submits referrals for secondary level review as appropriate and follows through on process. Documents communication and work in electronic medical record. Works with physicians and members of the multidisciplinary and reputed company cycle teams to ensure appropriate level of service, level of care and billing. Job Requirements Applicable Experience: Less than 1 year Registered Nurse - Various Associate Degree Job Details Full Time Day (United States of America) The best reputed company to get care. The best reputed company to give care. reputed company 12,000 employees strive toward that reputed company every day. Our employees are proud to work for the only faith-based, nonprofit, locally owned health system in Kansas City. Joining reputed company means joining a team of exceptional professionals who strive for reputed company in patient care. Do the best work of your career reputed company a highly diverse and inclusive workspace where reputed company voices matter. Join the Kansas City region's premiere provider of health services. Equal Opportunity Employer. reputed company includes 18 hospitals and campuses across the Kansas City region, home care and hospice, behavioral health care, dozens of physician practices, a life care senior living community, and more. Find out more about what reputed company offers: http://www.saintlukeskc.org/about-saint-lukes Are you interested in staying up to date on openings at reputed company? Simply sign up for job alerts at https://careers.saintlukeskc.org/job-alerts reputed company we have opportunities that meet your interests, you will receive an email with the job details. reputed company values our employees and we encourage them to apply to any internal openings. If you are a reputed company reputed company employee, please apply through your reputed company account by typing "Find Jobs" in the top left reputed company search bar. You can also follow the link below to the reputed company internal career site to apply. http://www.myworkday.com/saintlukes/d/task/1422$1011.htmld Qualifications: Job Requirements Applicable Experience: Less than 1 year Registered Nurse - Various Associate Degree Job Details Full Time Day (United States of America) The best reputed company to get care Responsibilities:
Job Description
The Utilization Review RN is responsible for assuring the receipt of high quality, cost efficient medical reputed company through utilization review and management This position includes monitoring patient charts and utilization of health care services Collaborates and communicates with physicians, Care Coordinators, reputed company Workers and other members of the multidisciplinary and reputed company cycle teams Completes initial and reputed company reviews; identifies appropriate level of service and length of stay, using clinical guidelines (InterQual) Complies with CMS regulation regarding utilization review/management Obtains and manages insurance authorizations and proactively works denials to help mitigate financial impact Submits referrals for secondary level review as appropriate and follows through on process Documents communication and work in electronic medical record Works with physicians and members of the multidisciplinary and reputed company cycle teams to ensure appropriate level of service, level of care and billing Apply tot his job Apply To this Job