Utilization Review RN Analyst

Location: King of Prussia, Pennsylvania, United States
Salary: US$60000 - US$67000 per annum + competitive
Sectors: Operations
Job Type: Permanent
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Responsibilities include:

  • Reviews admissions to determine medical necessity and appropriateness of treatment.
  • Secures necessary data for extended stay reviews.
  • Presents abstract (via telecon) of clinical course of treatment, to all various insurance companies and/or their contractual agencies, to justify continued treatment.
  • Reviews, abstracts and assigns initial length of stay and extensions of treatment, as appropriate, for Medicare, self-pay and private (non-precertification) insurance companies.
  • Communicates all extensions of treatment to clinical teams and Director, Utilization Review.
  • Attends daily treatment team meetings.

Qualifications include:

  • Graduate of accredited school of nursing; Bachelor's preferred.
  • Previous UR experience required
  • Previous experience in a behavioral health setting preferred
  • Requires good writing skills along with the ability to interpret chart terminology
  • Knowledge of addiction helpful

Sthree US is acting as an Employment Agency in relation to this vacancy.

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