Utilization Review RN
Tuba City, AZ
PRIDE Health
5x8 hrs, Days
Referral Bonus

Utilization Review RN

Location

• Tuba City, Arizona

Employment Type

• Contract

Schedule

• Monday to Friday, 8:00 AM to 5:00 PM
• Callback on weekends and holidays

Contract Length

• 13 weeks

Role Summary

• Reviews medical necessity and patient status, supports discharge planning and care transitions, helps reduce unnecessary length of stay, communicates with payers, and supports compliance, documentation, reporting, and quality improvement.

Required Qualifications

• Bachelor’s degree in Nursing
• Current, full, and unrestricted RN license in any U.S. state, Puerto Rico, or a U.S. territory
• Current Basic Life Support (BLS) certification from the American Heart Association
• 3 years of clinical nursing experience in direct patient care
• At least 2 years of that experience in an inpatient setting on a medical-surgical unit, PACU, ICU, Step-Down, Telemetry, or another higher-acuity inpatient unit, or in home health direct care
• Knowledge of case management, purchased referred care, and utilization review processes
• Knowledge of electronic health record systems

Compliance / Start Requirements

• Full compliance is required 2 weeks before the start date
• COVID and flu exemptions may be accepted after a declination form is submitted

Housing

• Shared contractor housing is available at limited availability and at additional cost
• No pets or family allowed per policy