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WVU MedicineWM

Utilization Review RN

WVU Medicine is the largest healthcare system in West Virginia, offering comprehensive services and innovative care.

WVU Medicine

Employee count: 1001-5000

United States only

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We are seeking a Utilization Review RN to examine medical records and develop concise clinical reviews to support authorization obtainment, avoid payment denial, and optimize reimbursement. The ideal candidate will have three years of healthcare clinical experience and a current Registered Nurse license.

Requirements

  • Current Registered Nurse license issued by the state in which services will be provided or current multi-state Registered Nurse license through the enhanced Nurse Licensure Compact (eNLC)
  • Three years of healthcare clinical experience
  • Bachelor's Degree in Nursing OR Associate of Science in Nursing Degree (ASN) or Diploma; Currently enrolled in a BSN program and BSN completion within three (3) years of hire
  • Medical Management for Medicare and/or Medicaid populations
  • Utilization Management experience

Benefits

  • Health insurance
  • Retirement plan
  • Paid time off
  • Holidays
  • Life insurance
  • Disability insurance

About the job

Apply before

Posted on

Job type

Full Time

Experience level

Mid-level

Location requirements

United States

Hiring timezones

United States +/- 0 hours

Job categories

Utilization Review NurseUtilization Review SpecialistClinical Utilization Review CoordinatorRN Utilization ReviewUtilization Review NursingUtilization Management NurseHealthcare Utilization Management Specialist

Skills

Registered NurseUtilization ManagementMedical Records ReviewMedicareMedicaidASNMedical ManagementClinical Review

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About WVU Medicine

Learn more about WVU Medicine and their company culture.

View company profile

West Virginia University Medicine is dedicated to providing comprehensive healthcare services throughout West Virginia and beyond. As part of the larger West Virginia University Healthcare system, we focus on improving the health and well-being of the communities we serve through advanced clinical care, education, and research. Our facilities are equipped with state-of-the-art technology, enabling our clinicians to offer the highest quality of care.

We are committed to fostering a culture of compassion and innovation. Our team of experienced healthcare professionals works diligently to deliver patient-centered care tailored to the specific needs of our patients. By advancing medical knowledge and employing cutting-edge treatments, WVU Medicine aims to create a healthier future for everyone in our region.

Claim this profileWVU Medicine logoWM

WVU Medicine

Company size

1001-5000 employees

Founded in

2014

Chief executive officer

Dr. Albert L. Wright Jr.

Markets

HealthcareHospital & Health Care ServicesMedical ResearchMedical EducationTelemedicineAcademic Medical CentersPatient Care ServicesHealth TechnologyClinical ServicesPublic Health

Employees live in

United States
View company profile

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