Cleveland, Ohio, 44102
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Job description
Job Summary
The Utilization Review Nurse plays a crucial role in evaluating the appropriateness and necessity of healthcare services provided to patients. The position aims to ensure that patients receive suitable care while effectively managing healthcare resources.
Responsibilities
- Assess patient records for the necessity of services in accordance with established guidelines.
- Collaborate with healthcare providers and insurance companies to facilitate care coordination.
- Document and communicate review findings to relevant stakeholders.
- Participate in quality assurance initiatives to enhance service delivery.
- Stay updated on healthcare regulations and best practices to ensure compliance.
Qualifications
- Registered Nurse (RN) license is required.
- Previous experience in utilization review or care management preferred.
- Strong analytical skills with attention to detail.
- Excellent communication and interpersonal abilities.
- Ability to work independently and as part of a team.
Location
Work Arrangement
Remote
Hunter Recruiting provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
