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(Archived) Utilization Review Nurse Opportunity in Pennsylvania
Last Updated: 3/05/21
Job Description
Utilization Review Nurse Opportunity in the suburbs of Philadelphia, PA
Seeking an experienced Utilization Review RN Analyst to join a behavioral health program. Full-time position. Not remote work.
Responsibilities include:
- Reviews admissions to determine medical necessity and appropriateness of treatment.
- Secures necessary data for extended stay reviews.
- Presents abstract (via telecon) of clinical course of treatment, to all various insurance companies and/or their contractual agencies, to justify continued treatment.
- Reviews, abstracts and assigns initial length of stay and extensions of treatment, as appropriate, for Medicare, self-pay and private (non-precertification) insurance companies.
- Communicates all extensions of treatment to clinical teams and Director, Utilization Review.
- Attends daily treatment team meetings.
Qualifications include:
- Graduate of accredited school of nursing; Bachelor's preferred.
- Previous UR experience required
- Previous experience in a behavioral health setting preferred
- Requires good writing skills along with the ability to interpret chart terminology
- Knowledge of addiction helpful
- UR experience in drug and alcohol and Supervisory experience a plus
Competitive salary and benefits package including health, dental, life insurance, paid time off, and retirement plan contributions.