Job Description. Job Description. Position Overview. The. Utilization Review Nurse. is responsible for coordinating all components of the utilization review process, which includes timely review of treatment requests for medical necessity, ensuring appropriate cost-effective treatment and promotion of best patient outcomes. The. Utilization Review Nurse. performs the initial clinical review, prepares an organized case summary and may issue certif...
Job Details. Job Location. MO, Jefferson City - Missouri Regional Office - JEFFERSON CITY, MO. Position Type. Per Diem. Education Level. Associate's Degree. Salary Range. Undisclosed. Travel Percentage. None. Job Shift. As Needed. Job Category. Nursing Professionals and Support. Description. Centurion is proud to be the provider of comprehensive healthcare services to the Missouri Department of Corrections. We are currently seeking a. PRN. Utiliz...
The Utilization Management (UM) Nurse is a licensed nursing professional responsible for reviewing UM cases and discharge planning activities. The UM Nurse may also assist with preparing files for audits and required reporting and ensuring UM cases are reviewed and processed within timeliness standards. The UM Nurse will work closely with the UM/QI Manager, MSO UM team, MSO Medical Director, and MSO Physician Reviewer on UM case reviews. The UM N...
PURPOSE OF THE POSITION. . The Utilization Management Nurse will conduct reviews of current inpatient services, and determine medical. appropriateness of inpatient and outpatient services following evaluation of medical guidelines and benefit determination in accordance with Utilization Management policies and procedures. ESSENTIAL FUNCTIONS. Perform utilization management, utilization review, or concurrent review (on-site at a hospital, or telep...
