Travel Nurse RN - Utilization Review
Irving, TX
TalentBurst, Inc
4x9 hrs, Days
$1,400/weekOverview
- Start DateASAP
- Shift Breakdown4x9 hrs
- ShiftDays
- Duration11 weeks
Pay
Description
Shift - Monday-Friday 8 hours
Hours - 40 hours/week
Location - Irving TX 75039
JOB SUMMARY
The RN Utilization Review II is responsible for determining the clinical appropriateness of care provided to patients and ensuring proper hospital resource utilization of services. This RN is responsible for performing a variety of pre-admission, concurrent, and retrospective UM related reviews and functions. They must competently and accurately utilize approved screening criteria (InterQual/MCG/Centers for Medicare and Medicaid Services "CMS” Inpatient List). They effectively and efficiently manage a diverse workload in a fast-paces, rapidly changing regulatory environment and are responsible for maintaining current and accurate knowledge regarding commercial and government payors and Joint Commission regulations and guidelines related to UM. This RN effectively communicates with internal and external clinical professionals, efficiently organizes the financial insurance care of the patients, and relays clinical data to insurance providers and vendors to obtain approved certification for services. The RN Utilization Review Nurse collaborates as necessary with other members of the health care team to ensure the above according to the mission of CHRISTUS. MAJOR JOB
RESPONSIBILITIES
• Applies demonstrated clinical competency and judgment in order to perform comprehensive assessments of clinical information and treatment plans and apply medical necessity criteria in order to determine appropriate level of care
• Resource/Utilization Management appropriateness: Assess assigned patient population for medical necessity, level of care and appropriateness of setting and services. Utilizes MCG/InterQual Care Guidelines and/or health system approved tools to track impact and variance
• Uses appropriate criteria se
Our client is a faith-based, not-for-profit health system comprising almost 350 services and facilities, including more than 60 hospitals and long-term care facilities, 175 clinics and outpatient centers and dozens of other health ministries and ventures.
#TB_HC
Employer
TalentBurst, Inc
Irving, TX
About
Irving, Texas, is a beautiful city famous for its quaint downtown area, scenic parks and top-rated schools. It offers many local attractions and landmarks, such as the Irving Arts Center, the Toyota Music Factory, the Las Colinas Canals and the Multicultural Western Heritage Museum. The city’s flourishing food scene features fantastic local restaurants like Sharko’s BBQ and CityGate Grille. Irving offers professional sports for every taste, as it’s home to the Dallas Cowboys (NFL), Dallas Mavericks (NBA) and Texas Rangers (MLB). Irving has plenty of opportunities for hiking, biking and other outdoor activities for those looking for a more active lifestyle. If Irving doesn’t pack enough punch, Dallas is only a few minutes away, offering even more culture, attractions and activities.
Browse similar jobs
Travel Nurse RN - Utilization Review
- Irving, TX
- Uniti Med
- 4x9 hrs, Days
- Referral Bonus
Travel Nurse RN - Utilization Review
- Irving, TX
- TRS Healthcare
- 5x8 hrs, Days
Travel Nurse RN - Case Manager, Utilization Review
- El Paso, TX
- Medical Solutions
- 5x8 hrs, Days
- Referral Bonus