Job Details
Quality Utilization Reviewer I
Main Campus Lee Building Day Shift Utilization Management Req # 195 Location 1620 4th Avenue South, Lee Building, Birmingham, Alabama Category Clinical Professional Schedule 7On-7Off Work Schedule 8-Hour Shifts Schedule Description 7am- 3:30pm, Monday- Sunday every other weekIn Utilization Management at Main Campus Lee Building
Work schedule will be 7on / 7off on the Day shift, 7am- 3:30pm, Monday- Sunday every other week.
Summary:
The UR Reviewer 1 is responsible for performing inpatient admission, concurrent, and observation reviews based on pre-established criteria exclusively for Medicaid and commercial payers other than BCBS AL. Upon successful completion of training by UR Reviewer 2 and with approval of UM Manager & Department Director, UR Reviewer 1 with RN licensure may advance to Nurse Reviewer 2 (If position becomes available).
Other information:
Knowledge of third party payer requirements in utilization review preferred.
Credentials with Equivalent Qualifications:
Essential:
* Registered Nurse AL Single State or any of the following equivalent qualifications below:
- Registered Nurse AL NLC Multi State
- Registered Nurse Non-AL NLC Multi State
- Licensed Practical Nurse AL Only
- Licensed Practical Nurse AL NLC Multi State
- Licensed Practical Nurse Non-AL NLC Multi State
- Licensed Independent Clinical Social Worker
Education with Equivalent Qualifications:
Essential:
* Associate of Science Nursing in Nursing or Bachelors of Science or Arts in Nursing
Experience with Equivalent Qualifications:
Essential:
* 2 Years Staff Level
Schedule: 7am- 3:30pm, Monday- Sunday every other week, Day Shift, 8-Hour Shifts
About the Location
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