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Newport Healthcare

UR Nurse or UR Specialist

Posted 14 hours ago
United Kingdom
0-2 years experience
microsoft-office behavioral-health
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AI Summary

The role involves obtaining behavioral health authorizations, conducting concurrent reviews, and tracking patient treatment progress across various levels of care. The specialist will also facilitate denial management and ensure compliance with third-party payor contract requirements.

What You’ll Do

  • Obtain initial behavioral health authorization and complete concurrent reviews.
  • Review the need for denial of stay with assigned clinical treatment team when patient no
    longer meets acute care criteria.
  • Facilitates appropriate action upon denial.
  • Maintains current level of knowledge on contract requirements of all third-party payor groups.
  • Tracks each patient’s course of treatment through inpatient, residential, partial hospitalization programs and IOP programs.
  • Oriented and educated in gender, cultural differences and in age-appropriate care for Utilization Review.
  • Perform other duties as assigned

What Makes You a Great Fit

  • Requires knowledge of nursing practices, which can be gained only through an accredited school of nursing. Current RN licensure with the State Board of Nursing is required.
  • Required to be knowledgeable of and follow the Nurse Practice Act
  • Previous 1 year utilization review experience required.
  • Knowledge of UR Standards of Excellence.
  • Display a professional attitude in all aspects of nursing performance.
  • Must be proficient in using Microsoft Office Products including Word and Outlook.

 


Additional Details

Pay Range for this position based on licensure and experience. This position requires working hours in the Central Time Zone. Utilization Review Specialist range $25 to $36.50. Utilization Review Nurse range $37.06 to $50.72
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