Utilization Review RN - Toledo Ohio

Company: VirtualVocations
Location: Toledo, Ohio
Posted On: 02/06/2025

A company is looking for a Utilization Review Nurse to join their Clinical Review team.



Key Responsibilities

Complete medical necessity and level of care reviews using clinical judgment and guidelines
Obtain necessary information to assess member's clinical condition and apply evidence-based guidelines
Refer members for further care engagement when needed and ensure compliance with applicable laws and regulations


Required Qualifications

Active, unrestricted RN licensure from the United States or compact multistate RN license
Associate Degree in Nursing or equivalent from an accredited nursing program
Ability to obtain additional state licenses as needed
1+ year of utilization review experience in a managed care setting
2+ years of clinical experience, including at least 1 year in an acute care setting More...

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