Inpatient Utilization Management Clinician (RN)
Posted 4 days ago by Talent Groups
Negotiable
Undetermined
Remote
Remote
Summary: The role of Inpatient Utilization Management Clinician (RN) involves conducting medical necessity reviews for inpatient admissions and continued stays, while collaborating with care teams to ensure compliance with guidelines and regulatory requirements. The position requires an experienced Registered Nurse with a strong background in inpatient utilization management. The clinician will play a critical role in maintaining quality care and adherence to evidence-based practices. This is a remote position.
Key Responsibilities:
- Perform medical necessity reviews for inpatient admissions and continued stays
- Collaborate with care teams to ensure compliance with evidence-based guidelines
- Ensure adherence to regulatory turnaround times
Key Skills:
- Active, unrestricted RN license (state of residence)
- 2+ years of inpatient utilization review / utilization management experience
- Strong working knowledge of InterQual guidelines
- Managed care / health plan experience preferred
- Strong clinical judgment, communication, and time management skills
Salary (Rate): £46 yearly
City: undetermined
Country: undetermined
Working Arrangements: remote
IR35 Status: undetermined
Seniority Level: undetermined
Industry: Other
We are looking for an experienced Registered Nurse (RN) with strong inpatient utilization management/utilization review experience to join our team. In this role, you will perform medical necessity reviews for inpatient admissions and continued stays, collaborate with care teams, and ensure compliance with evidence-based guidelines and regulatory turnaround times.
Required Skills:
- Active, unrestricted RN license (state of residence)
- 2+ years of inpatient utilization review / utilization management experience
- Strong working knowledge of InterQual guidelines
- Managed care / health plan experience preferred
- Strong clinical judgment, communication, and time management skills