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RN – Utilization Review (RN UR)
Job Title:
Registered Nurse – Utilization Review (RN UR)
Department:
Home Health
Full Time/PRN:
Full Time
Job Summary
Performs utilization review activities; coordinates with clinical teams, payers, and external agencies; ensures timely reviews and documentation in compliance with policy and HIPAA.
Minimum Qualifications
• RN/LPN or RHIT/RHIA trained/eligible OR non‑credentialed with UR experience and basic ICD‑10/InterQual knowledge.
Preferred Qualifications
• Prior UR experience and authorization process proficiency.
Essential Duties & Responsibilities
• Review cases per procedures/timelines; request additional info as needed.
• Communicate effectively; prioritize workload; follow up on incompletes.
• Operate office equipment and maintain confidentiality.
Physical Requirements
• Prolonged periods of sitting and computer work.
• Occasional standing, walking, bending, and reaching.
• Lift up to 25 lbs occasionally (files/supplies).
• Adequate vision, hearing, and speech to perform job duties and communicate effectively.
All candidates must be able to perform the essential functions of this position. The American with Disabilities Act (ADA) requires that reasonable accommodations be made for qualified individuals to help perform the essential functions of the position.
South Central Regional Medical Center is an equal opportunity employer and does not discriminate based on race, color, religion, sex, gender, national origin, age, disability, or genetic information.
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