We are currently seeking a per diem Utilization Review Nurse.
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The Utilization (UM) Nurse performs the review of requests for prior authorization of medical services, including diagnostic, outpatient care and services using defined criteria. Duties will include admissions through on-site and telephonic review to ensure medical necessity and appropriate level of care, review and audit of patient medical records as indicated to determine medical necessity, assistance in completion of Medicaid applications for patients currently hospitalized and serving as a clinical resource and liaison for site and hospital referral staff.
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