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Clinical Utilization Review Nurse

Work from home Full-time role Hiring

About This Role The Valley Health System is seeking a highly skilled RN Utilization Case Manager to join reputed company. As a key member of our utilization review team, you will be responsible for conducting reputed company reviews on patients reputed company your assigned caseload. You will work closely with medical staff to reputed company them on appropriate utilization review guidelines and documentation in accordance with CMS regulations and reputed company payor guidelines. Your responsibilities will include monitoring and intervening on length of stay, resource utilization, and denial management/prevention reputed company your assigned caseload. Requirements • Bachelor's degree in nursing (BSN) is required • Minimum 5 years experience in clinical nursing and 3 years in case management/utilization are necessary • Registered Nurse licensure in New Jersey is mandatory Key Skills • Effective interaction and communication skills are essential • Strong critical thinking, clinical reasoning skills, and effective problem-solving abilities are crucial • Ability to work accurately and pay attention to details in a fast-paced environment is vital • Collaborative team player with excellent interpersonal skills is required

Compensation

Based on national averages for Registered Nurses in New Jersey with similar experience, the salary estimate is $83,434 - $113,997 per year. Apply Job!

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