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Description
TalentBurst, Inc is seeking a travel nurse RN Utilization Review for a travel nursing job in Irving, Texas.
Job Description & Requirements
- Specialty: Utilization Review
- Discipline: RN
- Start Date: 06/17/2024
- Duration: 11 weeks
- 36 hours per week
- Shift: 12 hours
- Employment Type: Travel
Position - RN Utilization Review
Shift - Monday-Friday 8 hours
Hours - 40 hours/week
Location - Irving TX 75039
JOB SUMMARY
The RN Utilization Review II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This RN is responsible for performing a variety of pre-admission, concurrent, and retrospective UM related reviews and functions. They must competently and accurately utilize approved screening criteria (InterQual/MCG/Centers for Medicare and Medicaid Services "CMS” Inpatient List). They effectively and efficiently manage a diverse workload in a fast-paces, rapidly changing regulatory environment and are responsible for maintaining current and accurate knowledge regarding commercial and government payors and Joint Commission regulations and guidelines related to UM. This RN effectively communicates with internal and external clinical professionals, efficiently organizes the financial insurance care of the patients, and relays clinical data to insurance providers and vendors to obtain approved certification for services. The RN Utilization Review Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS. MAJOR JOB
RESPONSIBILITIES
• Applies demonstrated clinical competency and judgment in order to perform comprehensive assessments of clinical information and treatment plans and apply medical necessity criteria in order to determine appropriate level of care
• Resource/Utilization Management appropriateness: Assess assigned patient population for medical necessity, level of care and appropriateness of setting and services. Utilizes MCG/InterQual Care Guidelines and/or health system approved tools to track impact and variance
• Uses appropriate criteria se
Our client is a faith-based, not-for-profit health system comprising almost 350 services and facilities, including more than 60 hospitals and long-term care facilities, 175 clinics and outpatient centers and dozens of other health ministries and ventures.
#TB_HC
Talent Burst Job ID #24-09016. Pay package is based on 12 hour shifts and 36 hours per week (subject to confirmation) with tax-free stipend amount to be determined. Posted job title: Registered Nurse Utilization Review 1366
About TalentBurst, Inc
TalentBurst Health & Life Sciences is an established provider of healthcare workforce solutions, servicing healthcare facilities across the United States for over 15 years. As a Joint Commission Certified Agency, our commitment to quality, integrity, and exceptional service has made us a trusted name in the healthcare staffing landscape.
Our mission is to bridge the gap between healthcare professionals seeking fulfilling opportunities and healthcare organizations striving to maintain their high standards of care. We are committed to providing top-notch healthcare professionals with access to facilities where they can focus on delivering exceptional patient care and thrive.
Whether you're a nurse, allied health professional, or administrative personnel, we have the expertise to match your skills and aspirations with the perfect placement.
