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POSITION SUMMARY
The Utilization Review Nurse is responsible for ensuring the medical necessity and appropriate level of care of all hospital admissions and extended hospital stays, including psychiatry; affirming compliance with CMS’ Conditions of Participation regarding Utilization Management with annual review of the UM Plan and assisting with the coordination of the Utilization Management Committee; Knowledge of CMS policy, guidance and criteria as well as those of various managed care insurance plans.
MINIMUM REQUIREMENTS
State of Vermont Registered Nurse (RN) license required. The University of Vermont Health Network is moving toward an all Bachelor of Science in Nursing (BSN) workforce.
PRIOR EXPERIENCE
3-5 years acute care hospital nurse and/or
3-5 years chart review, prior authorizations, managed care, familiarity of clinical documentation requirements
Full Time
Ambulatory Healthcare Services
$83k-104k (estimate)
04/29/2024
05/08/2024
uvmhealth.org
SOUTH BURLINGTON, VT
3,000 - 7,500
2011
Private
NATHANIEL NELMS
$1B - $3B
Ambulatory Healthcare Services
UVM Health Network owns and operates a chain of healthcare centers that specializes in cardiovascular and critical care treatments.
The job skills required for Utilization Review Nurse include Acute Care, etc. Having related job skills and expertise will give you an advantage when applying to be an Utilization Review Nurse. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Utilization Review Nurse. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Utilization Review Nurse positions, which can be used as a reference in future career path planning. As an Utilization Review Nurse, it can be promoted into senior positions as a Clinical Outcomes Manager that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Utilization Review Nurse. You can explore the career advancement for an Utilization Review Nurse below and select your interested title to get hiring information.