Utilization Review Nurse - 249106

🩺 What You’ll Do: Reviews current inpatient or ongoing treatment plans Checks medical records, labs, and physician notes Communicates with doctors, case managers, and care teams Applies clinical guidelines like MCGDetermines if the level of care (inpatient vs observation) is appropriate Recommends continued stay, discharge, or alternative care settings✅ Required Qualifications

• Active, unrestricted RN license (single state or compact/NLC)
• Associate or Bachelor’s Degree in Nursing (or accredited program graduate)
• Experience with MCG guidelines
• Ability to obtain additional state licenses if needed
• 1+ year of utilization review experience doing concurrent reviews (managed care)
• 1+ year of clinical experience in an acute care setting (ER, hospital, etc.)