Utilization Review RN ARRMC (Case Management) - Remote

The Utilization Review RN monitors utilization practices from preadmission to discharge to assure cost-effective utilization of resources, quality patient care, and compliance with regulatory requirements. This role is responsible for reviewing the medical record to ensure documentation demonstrates medical necessity according to regulatory guidelines. The Utilization Review RN will actively manage and communicate with key members of the care team to secure accurate documentation and admission status. Utilization Review RN ARRMC (Case Management) - Remote Additional Position Details: FTE: 1.000000 | Full Time | Primarily Mon - Fri / 8AM - 5PM Please Note: This is a remote position. Candidates will be required to have reliable broadband internet and personal cell phone service. Remote work may include online training and working day-to-day operations during Pacific Standard business hours. Starting Wage: $49.34-$67.84 per hour, depending on experience

Receiving and disseminating information related to system, departmental, and patient processes Participating in data collection activities to support departmental programs and services Monitoring and reporting on patient outcomes and actively working with other members of the interdisciplinary team to facilitate improved delivery of cost-effective services Conducting utilization review, evaluating clinical information, and communicating findings to payors within the framework of contractual and government regulations Reviewing all admissions for appropriate inpatient vs. outpatient/observation status