Utilization Review Nurse (PRN/Day Shift)

The Utilization Review (UR) Nurse is responsible for conducting admission and continued stay reviews to ensure appropriate utilization of hospital resources and compliance with medical necessity criteria, payer requirements, regulatory standards, and organizational policies. The UR Nurse works collaboratively with physicians, case managers, revenue cycle staff, and interdisciplinary care teams to facilitate appropriate patient status determinations and optimize reimbursement while supporting quality patient care. This position requires extensive acute care nursing experience and demonstrated expertise in utilization review within a hospital setting. This is a PRN position and is subject to the organization’s PRN scheduling, shift, and holiday requirements described below.  4 or 8 hour shifts during the 7a-7p hours.