Utilization Review Nurse

Overview:

• As a patient-focused organization, University of Utah Health exists to enhance health and well-being through patient care, research, and education.
• Success requires a culture of collaboration, excellence, leadership, and respect.

Responsibilities:

• Applies approved utilization criteria to monitor appropriateness of admissions with associated levels of care and continued stay reviews.
• Communicates to third-party payers for initial and concurrent clinical review and documents all actions.
• Tracks length of stay and resource utilization to identify at-risk patients and refers to UR committee as needed.

Qualifications:

• Requires one year of Utilization Review or Case Management experience.
• Must hold a current license to practice as a Registered Nurse in Utah or obtain within 90 days under interstate compact.
• Preferred: Basic Life Support, proficiency in InterQual Criteria, ICD-9, DRG, CPT codes, and UR Certification.

Working Conditions:

• This is a sedentary position in an office setting, exerting up to 10 pounds.
• Involves sitting most of the time and is not exposed to adverse environmental conditions.
• This position does not provide direct care to patients.