Utilization Review Nurse job at Careerbuilder-US Harrisburg, PA, US

Job Description

Minimum Qualifications:

Possession of a current license to practice as a Registered Nurse issued by the Pennsylvania State Board of Nursing; or Possession of a non-renewable temporary practice permit issued by the Pennsylvania State Board of Nursing.
Resources possessing non-renewable temporary practice permits must obtain licensure as a Registered Nurse within the one-year period as defined by the Pennsylvania State Board of Nursing.
Proficient writing and basic Computer Skills to include, but not limited to, Microsoft Office Products
Three years of professional experience with medical assistance (MA), health care services, or human services
Minimum of three years of recent (within the last five years) professional experience in one or more of the following areas as related to the position need: long term care, acute care setting, behavioral health setting, drug and alcohol setting, managed care, quality management/utilization review or other related clinical experience; or
An equivalent combination of experience and training in the field of medical assistance (MA), health care services, human services, long term care, utilization review, or knowledge of home care
Knowledge of and familiarity with the following would be beneficial: Inter- Qual criteria, ICD-9 CM, and current procedure terminology,
Ability to use professional judgment in identifying aberrant patterns and determining the appropriate action to be taken following the documentation review.

Job Tags

Temporary work, Work at office,

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