Utilization Review Registered Nurse, PRN
Trinity HealthOur take on this role
About this role
Review hospital care using established medical necessity criteria to support patient status decisions and appropriate resource use. Serve as a liaison between the hospital and external payers.
What could you bring from clinical work?
- Nurses: Reviewing clinical records for illness severity and hospital care needs could help you conduct medical necessity reviews and support patient status decisions.
Full job description from Trinity Health
Employment Type: Part time Shift:
Description: Position Summary: The Utilization Review (UR) Coordinator collaborates with a multidisciplinary team, including physicians, nurses, patient access staff, billing personnel, and external payers, to ensure patients receive the appropriate level of care throughout the continuum of care in an efficient, cost-effective, and quality-focused manner. The UR Coordinator conducts clinical reviews using established medical necessity criteria to support accurate patient status determinations and appropriate resource utilization throughout hospitalization. This role serves as a liaison between the hospital and external payers regarding medical necessity, severity of illness, intensity of service, authorization requirements, and timely utilization of hospital services.
Our Commitment
Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.