Company Overview
[$COMPANY_OVERVIEW]
Role Overview
We are seeking a dedicated and detail-oriented Entry-Level Utilization Review Nurse to join our dynamic healthcare team. In this role, you will play a critical part in assessing the appropriateness of medical services and ensuring that patients receive the right care at the right time. This is an excellent opportunity for recent nursing graduates or those new to the field to gain valuable experience while making a positive impact in patient care.
Responsibilities
- Conduct comprehensive reviews of patient medical records to assess the necessity and appropriateness of proposed treatments and services.
- Collaborate with healthcare providers to gather information and clarify treatment plans, ensuring adherence to clinical guidelines and protocols.
- Utilize established criteria and guidelines to evaluate patient care and make informed decisions regarding authorization requests.
- Document findings and decisions clearly and accurately in our electronic health record system.
- Participate in case conferences and collaborate with multidisciplinary teams to discuss complex cases and contribute to care planning.
- Stay updated on changes in healthcare regulations and industry standards that may affect utilization review processes.
Required and Preferred Qualifications
Required:
- Active Registered Nurse (RN) license in good standing.
- Strong analytical skills and attention to detail.
- Excellent verbal and written communication skills.
- Basic understanding of medical terminology and healthcare regulations.
Preferred:
- Experience in a clinical setting, preferably in acute care or related fields.
- Familiarity with electronic health record systems and utilization review processes.
- Certification in Utilization Review (CPUR) or related credentials (or willingness to obtain).
Technical Skills and Relevant Technologies
- Proficient in Microsoft Office Suite (Word, Excel, PowerPoint).
- Experience with electronic health record (EHR) systems.
- Knowledge of utilization management software and clinical decision support tools.
Soft Skills and Cultural Fit
- Demonstrated ability to work effectively in a remote team environment.
- Strong interpersonal skills with a focus on collaboration and teamwork.
- Ability to manage multiple tasks and prioritize effectively in a fast-paced environment.
- A commitment to providing high-quality patient care and continuous learning.
Benefits and Perks
Salary: [$SALARY_RANGE]
As a full-time employee, you will enjoy a comprehensive benefits package that includes:
- Health, dental, and vision insurance plans.
- 401(k) retirement plan with company match.
- Generous paid time off (PTO) and holidays.
- Opportunities for professional development and continuing education.
- Employee wellness programs and resources.
Equal Opportunity Statement
[$COMPANY_NAME] is committed to fostering a diverse and inclusive workplace. We are proud to be an Equal Opportunity Employer and welcome applicants from all backgrounds, experiences, and perspectives. All qualified applicants will receive consideration for employment without regard to race, color, religion, creed, gender, national origin, age, disability, veteran status, sexual orientation, gender identity, or any other basis protected by applicable law.
Location
This is a fully remote position, allowing you to work from anywhere.
We encourage applicants from diverse backgrounds and experiences to apply, even if you do not meet all the qualifications listed. Your unique perspective and passion for patient care are what we value most!