Location: Pennsylvania - Eagleville
Duration: Full Time
Job ID: 975 (22396305)
Category: Risk Management RN Job
Contact: April Estes Call: 7204392609
Practice Type: Private
Job Salary: Competitive
Job Posted: 01/26/21
Utilization Review Nurse - 975 (22396305)
This is an onsite position and does not currently allow for remote work. Position can be in Eagleville, PA or Norristown, PA.
- Reviews admissions to determine medical necessity and appropriateness of treatment.
- Secures necessary data for extended stay reviews.
- Presents abstract (via telecon) of clinical course of treatment, to all various insurance companies and/or their contractual agencies, to justify continued treatment.
- Reviews, abstracts and assigns initial length of stay and extensions of treatment, as appropriate, for Medicare, self-pay and private (non-precertification) insurance companies.
- Communicates all extensions of treatment to clinical teams and Director, Utilization Review.
- Attends daily treatment team meetings.
- Graduate of accredited school of nursing; Bachelor's preferred.
- Previous UR experience required
- Previous experience in a behavioral health setting preferred
- Requires good writing skills along with the ability to interpret chart terminology
- Knowledge of addiction helpful