Utilization Review Specialist

POSITION SUMMARY: Responsible and accountable for performing the hospital utilization review function.# Each Utilization Review Specialist will coordinate the utilization review activities and assure compliance with federal, state, and third-party payer guidelines.# The Utilization Review Specialist will act as a liaison between the hospital and outside review agencies.

EDUCATION, CREDENTIALS, TRAINING and EXPERIENCE: Minimum Required: Graduate of an accredited school of professional nursing, with current license to practice as a Registered Nurse in North Carolina with at least 3 years# experience in an acute care setting. Preferred:# BSN and previous Utilization Review experience.

POSITION SUMMARY: Responsible and accountable for performing the hospital utilization review function.

Each Utilization Review Specialist will coordinate the utilization review activities and assure compliance with federal, state, and third-party payer guidelines. The Utilization Review Specialist will act as a liaison between the hospital and outside review agencies.

EDUCATION, CREDENTIALS, TRAINING and EXPERIENCE:

Minimum Required: Graduate of an accredited school of professional nursing, with current license to practice as a Registered Nurse in North Carolina with at least 3 years' experience in an acute care setting.

Preferred: BSN and previous Utilization Review experience.