Utilization Review Nurse Job at Fusion HCR, Las Vegas, NV

  • Fusion HCR
  • Las Vegas, NV

Job Description

Fusion HCR Hiring Direct Hire – Utilization Review NurseThis is an onsite position working with our client in Acute Care. Seeking an experienced Utilization Review Nurse (RN) to review patient admissions for medical necessity, appropriate level of care, and compliance with payer guidelines. This role works closely with clinical teams to ensure efficient resource utilization and quality patient outcomes.ResponsibilitiesReview admissions using InterQual and/or Milliman criteriaEvaluate medical necessity, level of care, and documentation accuracyEnsure compliance with Medicare, Medicaid, and regulatory guidelinesCollaborate with physicians, case management, and care teamsSupport discharge planning and care coordinationDocument findings and communicate recommendationsRequirementsActive RN license (Nevada)5+ years acute care nursing experience3+ years Utilization Review experience3+ years discharge planning experience (acute care)Experience with InterQual (must be able to pass exam)Experience with Milliman guidelinesPreferredBackground in Case Management or CDIStrong knowledge of Joint Commission and CMS guidelinesWhy ApplyCompetitive payStable, high-demand roleCollaborative healthcare environmentIf you have strong Utilization Review, InterQual, and acute care experience, we want to hear from you!

Job Tags

Similar Jobs

Veracity

Utilization Review Registered Nurse Job at Veracity

 ...UR Review Case Manager (Admin)The Utilization Review/Case Manager is responsible for facilitating the appropriate use of hospital resources by ensuring...  ...duties as assigned. Graduate of an accredited school of nursing required. Current RN License in the State of... 

INTERACTION 24 LLC

Piezoelectric Ceramic Engineer - Ceramic Processing and Sintering Job at INTERACTION 24 LLC

 ...Job Description Benefits: Competitive salary Training & development InterAction24 is hiring a full-time Piezoelectric Ceramic Engineer for an advanced piezoelectric materials manufacturer in central Pennsylvania (State College area). This is a direct-hire,... 

University of Texas Medical Branch Health

Senior Environmental Health & Safety (EHS) Specialist - EHS-Environmental Radiation Safety Job at University of Texas Medical Branch Health

Senior Safety Specialist Minimum Qualifications:Bachelor's degree in an environmental, natural...  ...technical position in the UTMB-EHS, Radiation & Occupational Safety group. As a senior...  ...Standard hospital, clinical, laboratory and/or office environments.Potential exposure to... 

RD NUTRITION CONSULTANTS LLC

Registered Dietitian (RD) - 100% Remote Telehealth Job at RD NUTRITION CONSULTANTS LLC

 ...Nutritionist This is a remote position. Part-Time Telehealth Registered Dietitian...  ...telehealth-based role with a flexible work-from-home schedule Pay: Competitive hourly rate of...  ...Specialist) preferred Availability on evenings and Saturdays preferred RD Nutrition Consultants... 

LocumJobsNetwork

Locum Nurse Practitioner (NP) - Pediatrics - General/Other in Michigan Job at LocumJobsNetwork

 ...Nurse Practitioner | Pediatrics - General/Other Location: Michigan Employer: LocumTenens.com Pay: Competitive weekly pay (inquire for details...  ...: Top Reasons to Choose a Locum Tenens Assignment Explore telemedicine or remote healthcare opportunities through locum...