Utilization Review RN ARRMC (Case Management)

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Utilization Review RN ARRMC (Case Management) Additional Position Details: FTE: 0.900000 | Full Time | Variable Hours/Variable Days Salary: Starting at $45.26 an hour and increases are based on qualifications and years of experience in the field. Plus, you will earn extra shift differentials for weekend hours: $2.20 extra for working weekends PLEASE NOTE: This position may be remote. Candidates will be required to have reliable broadband internet and personal cell phone service. Remote work may include working day-to-day operations during Pacific Standard business hours or online training. Position Summary The Utilization Review Nurse monitors utilization practices from preadmission to discharge to assure cost-effective, quality patient care and to ensure that patient, physician, and hospital/system receive maximum benefits from the health plan. Also ensures compliance with all regulatory requirements involved in the continuum of care.

Receiving and disseminating information related to system, departmental, and patient processes Participating in data collection activities to support departmental programs and services Monitoring and reporting on patient outcomes and actively working with other members of the interdisciplinary team to facilitate improved delivery of cost-effective services Conducting utilization review, evaluating clinical information, and communicating findings to payors within the framework of contractual and government regulations Reviewing all admissions for appropriate inpatient vs. outpatient / observation status