Utilization Review Nurse

Utilization Review Nurse - 975 (22396305)

Position Overview: 
This is an onsite position and does not currently allow for remote work.  Position can be in Eagleville, PA or Norristown, PA.

Responsibilities:

• 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.

Required Qualifications: 

• 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