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Utilization Review Nurse

Eagleville, PA
Job description
Eagleville Hospital is currently seeking a full time Utilization Review RN Analyst. 
Responsibilities include:
  • Reviews admissions to determine medical necessity and appropriateness of treatment.
  • Secures necessary data for extended stay reviews.
  • Presents abstract (via telecon) of clinical course of treatment, to all various insurance companies and/or their contractual agencies, to justify continued treatment.
  • Reviews, abstracts and assigns initial length of stay and extensions of treatment, as appropriate, for Medicare, self-pay and private (non-precertification) insurance companies.
  • Communicates all extensions of treatment to clinical teams and Director, Utilization Review.
  • Attends daily treatment team meetings.
Qualifications include:
  • Graduate of accredited school of nursing; Bachelor's preferred.
  • Previous UR experience required
  • Previous experience in a behavioral health setting preferred 
  • Requires good writing skills along with the ability to interpret chart terminology
  • Knowledge of addiction helpful
Eagleville Hospital, located in Montgomery County, Pennsylvania, is a private non-profit organization dedicated to the treatment, education, and prevention of substance abuse and co-occurring disorders.  The hospital serves as a regional resource for the treatment and prevention of alcohol and drug abuse, as well as a national resource for training and research for addiction and related conditions. 
We offer a competitive salary and benefits package including health, dental, life insurance, paid time off, and retirement plan contributions. 
EOE
www.rsmcservices.com 

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