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PRN Utilization Review Clinical Specialist (Remote


PayCompetitive
LocationFranklin/Tennessee
Employment typePart-Time

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  • Job Description

      Req#: 300000408206031
      Employer Industry: Healthcare Services

      Why consider this job opportunity:
      - Opportunity for career advancement and growth within the organization
      - Work up to 40 hours per week with flexible scheduling
      - Supportive and collaborative work environment
      - Chance to make a positive impact on patient care and documentation accuracy
      - Engage in a variety of clinical assessments and collaborative discussions with medical staff

      What to Expect (Job Responsibilities):
      - Perform initial clinical assessments and continued stay assessments to establish medical necessity for hospitalized patients
      - Collaborate with physicians on documentation to support hospital medical necessity and discharge needs
      - Document all actions in the case management software system, including clinical reviews and payer contacts
      - Coordinate with Emergency Room staff on potential admissions to validate inpatient or outpatient status
      - Educate healthcare teams on appropriate documentation to support levels of care

      What is Required (Qualifications):
      - Required Education: Associate's Degree in Nursing
      - Minimum of 3 years previous nursing experience
      - Required License: Licensed Practical Nurse or Licensed Registered Nurse
      - Data entry skills and proficiency with Google Docs, Google Sheets, and email applications
      - Exceptional communication and collaboration skills

      How to Stand Out (Preferred Qualifications):
      - Bachelor's Degree in Nursing or higher
      - 3+ years of Utilization Review experience
      - ACM or CCM Certification

      #HealthcareServices #UtilizationManagement #NursingCareers #PatientAdvocacy #CareerOpportunity

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