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Job description
Job Description
Job Summary:
Seeking an experienced Registered Nurse specializing in utilization review to assess non-acute cases. This role involves evaluating patient records to ensure appropriate care and resource utilization while maintaining compliance with regulatory and organizational standards.
Responsibilities:
Analyze patient records and clinical documentation to determine appropriate utilization of healthcare services.
Collaborate with multidisciplinary teams to review and approve care plans based on established criteria.
Document findings and maintain accurate, detailed records to support compliance and reporting.
Stay current with regulatory standards and best practices related to utilization review and patient care.
Participate in ongoing training and professional development activities to enhance review skills.
Assist in continuous quality improvement initiatives related to clinical utilization.
Qualifications: Possess a valid New York State RN license.
Have at least 1 year of non-acute utilization review experience.
Demonstrate proficiency in primary source verification and AHA BLS certification.
Exhibit strong clinical judgment and attention to detail.
Communicate effectively with healthcare teams and external reviewers.
Maintain compliance with all relevant healthcare regulations and organizational policies.
Benefits & Growth: Access to ongoing professional development opportunities.
Supportive environment that encourages career advancement within healthcare administration and review.
Benefits Day 1 Medical, Dental, and Vision insurance
Travel reimbursement for assignments
Paid sick leave and additional valuable benefits
Access to our $1,000 Inspire a Friend Referral Program
Why TactStaff?
Choosing TactStaff means partnering with a team that understands the unique demands and rewards of Utilization Review / CDI . We're here to provide you with meaningful assignments that support your professional growth while ensuring each role is a step toward achieving your long-term career goals.
Apply today to experience how TactStaff can elevate your Utilization Review / CDI career!
Worksite address
east elmhurst, NY, 11370, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.