Healthcare Support Staffing Verified 6d ago
Utilization Review Nurse
Tampa, FL, United States On-site
$60,320–$62,400 a yearPay$60,320–$62,400
TypeFull-time
Work settingOn-site
Verified listing
JobFig found this opening at its original source and checks that it remains available.
About the role
You, as the Nurse Reviewer will be held responsible for the comprehensive review of the medical information for the assigned medical record review and completion of all paperwork, communication and data entry involved. Reviews will include quality of care, medical necessity; DRG validation, focused, readmission, Emergency Medical Treatment and Active Labor Act [EMTALA], and all others are required by contract. Communicates with the Medicare beneficiary/family members, healthcare providers and/or practitioners as needed during the course of the identified review.
What you'll bring
- Active RN or LPN Licensure
- Graduate from an accredited School of Nursing or college
- 3+ years of clinical experience within any healthcare setting [Acute Care, Inpatient, Outpatient, etc]
- Quality Review experience [Medical Necessity, Utilization Review/Management, HEDIS, Chart Auditing, Medical Record Reviews]