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UR Nurse or UR Specialist

Newport Healthcare

Role overview

Qualifications

  • Current RN licensure with the State Board of Nursing
  • Previous 1 year utilization review experience
  • Knowledge of nursing practices and UR Standards of Excellence
  • Proficient in using Microsoft Office Products including Word and Outlook

Responsibilities

  • Obtain initial behavioral health authorization and complete concurrent reviews
  • Review the need for denial of stay with assigned clinical treatment team
  • Facilitates appropriate action upon denial
  • Tracks each patient’s course of treatment through various programs

Key facts

Hard skills

Other skills

  • Microsoft Office
  • Professionalism

About the company

Newport Healthcare logo

Newport Healthcare

Hospitals & Health Care

Behavioral health treatment including primary mental health concerns such as anxiety and depression and co-occurring disorders such as substance abuse, trauma-related issues, and eating disorders. Levels of care include residential, partial hospitalization/intensive outpatient programming, and day schools. Programs include Newport Academy for adolescents and Newport Institute for young adults.

Company details

Company typeLarge
IndustryHospitals & Health Care
Company size1001 - 5000

Links

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Job description

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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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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