Utilization Review RN

HealthCare Support Staffing, Inc. (HSS), is a proven industry-leading national healthcare recruiting and staffing firm. HSS has a proven history of placing talented healthcare professionals in clinical and non-clinical positions with some of the largest and most prestigious healthcare facilities including: Fortune 100 Health Plans, Mail Order Pharmacies, Medical Billing Centers, Hospitals, Laboratories, Surgery Centers, Private Practices, and many other healthcare facilities throughout the United States. HealthCare Support Staffing maintains strong relationships with top providers in healthcare and can assure healthcare professionals they will receive fast access to great career opportunities that best fit their expertise. Connect with one of our Professional Recruiting Consultants today to see how a conversation can turn into a long-lasting and rewarding career!

Job Title: Utilization Review RN

Are you an experienced Registered Nurse with Utilization Review experience professional looking for a new opportunity with a prestigious healthcare company? Do you want the chance to advance your career by joining a rapidly growing company? If you answered “yes" to any of these questions – this is the position for you!

Position Summary:

As the Utilization Review RN, you would be responsible for telephonically reviewing medical information in order to determine medical necessity of continued stay according to review standards. 

Hours for this Position: Monday-Friday 8:00am-5:00pm

Advantages of this Opportunity:

• Competitive salary, negotiable based on experience
• Benefits offered, Medical, Dental, and Vision
• Fun and positive work environment
• Weekly deposit options

More Insight of Daily Responsibilities: 

• Ensures that services provided to eligible members are within benefit plan and appropriate contracted providers are being utilized
• Determines medical necessity and length of stay based on the consistent application of CMS criteria
• Assesses and coordinates simple discharge planning
• Identifies quality of care issues

What We Look For:

• RN license in the state of TN
• Bachelor's Degree in related field
• 2+ years of experience in UM, UR, pre-authorization, concurrent review, discharge planning and/or skilled nursing