Utilization Review RN

Posted December 12, 2024
Apply: InGenesis


Job Description:

Utilization Review Nurse (RN)

Work Location: Anchorage, AK

Job Summary/Description

We have an exciting opportunity available for aUtilization Review Nurse (RN)to come work with Joint Base Elmendorf-Richardson located in Anchorage, AK. As the UR Nurse, you'll work behind the scenes to maximize cost efficiency and quality of various health care services. Through reviews and audits, you'll ensure that patients receive care they need without burdening health care system with unnecessary procedures, ineffective treatments and/or overlong hospital stays. It may also be your duty to educate and inform patients on the benefits and limitations of their specific health care coverage. So, if you're ready to provide patients with information that they need, thenapply nowto begin the recruiting process today!

Job Duties/Responsibilities/Functions(including but not limited to)
  • Investigates assigned cases - obtains and organizes/labels clinical documents; conducts research on internal databases and outside sources as needed; prepares a written summary of medical and related records relevant to the PQI; determines appropriate review level based on departmental protocols and case findings; records comprehensive rationale for case closure or escalation to next level review.
  • Prepares cases on-line using department database.
  • Presents case review summaries/finding to Medical Director at weekly Case Review Meetings as appropriate.
  • Prepares and follows case for subsequent multi-level reviews as needed.
  • Perform other duties as assigned.

Minimum Qualifications
  • Active Registered Nurse License (RN)
  • 2 years Nursing Experience
  • Quality Management Experience

EEO Statement:
InGenesis is proud to be an affirmative action employer and is committed to providing equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. If you have a disability or special need that requires accommodation in the hiring process, please let us know by visiting our website at https://www.ingenesis.com/careers/site-accommodations

Company Statement:
InGenesis is one of the largest staffing firms in the industry and is among the largest diversity-owned healthcare staffing firms in North America. InGenesis is dedicated to placing people in positions that preserve life, improve lives, and inspire others. This does not happen without passionate people: skilled colleagues who are motivated to create innovative solutions and deliver superior service to our clients. InGenesis counts almost half of the Fortune 500 in our nearly 300 clients, including clients in the healthcare, life sciences, higher education and pharma industries.