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    CO

    Cone Health

    Healthcare

    RN Utilization Review

    Cone Health, United StatesHybridFull-timePosted 1mo ago
    All Cone Health jobs

    Job description

    Registered Nurses Mon-Fri

    Excited to grow your career?
    We value our talented employees, and whenever possible strive to help one of our associates grow professionally before recruiting new talent to our open positions. If you think the open position you see is right for you, we encourage you to apply!
    Our people make all the difference in our success.

    A Registered Nurse (RN) 3 Utilization Review monitors and evaluates patient care utilization. Working under minimal supervision, this role manages projects and processes within the utilization review group and provides expert counsel to the organization on the optimal use of healthcare resources in alignment with patient needs and regulatory compliance.

    Essential Job Functions:

    • Reviews patient needs and conditions to deliver nursing care within the assigned unit to ensure that every patient receives the direct and proper care needed.

    • Reviews patient records and develops strategies to optimize healthcare resource utilization.

    • Prepares reports and examines trends to identify opportunities for efficiency and quality improvements.

    • Applies knowledge of utilization review methodologies to serve as a resource for training and ensuring compliance with regulations.

    • Seeks guidance from senior management as needed to clarify coverage and utilization criteria.

    • Performs other duties as assigned.

    Education:

    • Required: Bachelor's of Nursing Degree.

    Experience:

    • Required: 2 years of cumulative experience as practicing RN.

    Licensure/Certification/Listing:

    • Required: Registered Nurse license in North Carolina or a Compact state.

    • BLS (CPR)-American Red Cross or AHA Healthcare Provider.

    • National certification in clinical specialty area.

    Work Shift :

    Days/No Weekends (United States of America)

    On Call Required

    No

    FTE:

    1

    Job Type:

    Full Time (40 Hours/Week)

    Job details are sourced from the employer's original posting.

    Open job posting
    CO

    About the company

    Cone Health

    Recognized for Excellence in Neurology Moses H. Cone Memorial Hospital ranks in the top 10 percent of the nation for medical excellence in neurological care, according to CareChex . That means you can trust us to provide advanced inpatient services, protect patient safety, and offer care with lower-than-average rates of complications. Cone Health has been named a Blue Distinction Center+ for Spine Surgery by Blue Cross and Blue Shield of North Carolina (BCBSNC). Hospitals with this designation demonstrate expertise in cervical and lumbar fusion, cervical laminectomy and lumbar laminectomy/discectomy procedures, resulting in fewer patient complications and hospital readmissions compared to other hospitals. Our outstanding services include stroke care at Moses Cone Hospital and other Cone Health facilities, which have earned numerous recognitions for helping stroke patients achieve better-than-average outcomes.

    View all Cone Health jobs
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