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Utilization Review RN

Grand Rapids, Michigan 49525

Category: Health Job Number: 15702

Voca Health has immediate openings available for  Utilization Review Registered Nurse (RN) professionals in Grand Rapids, MI!

 

Voca connects Travel Nurses, Nurse Practitioners, LPNs, CNAs, and other clinical professionals with fantastic health systems nationwide. Our goal is full partnership with our travelers, providing the tools, guidance, and opportunities to help our travelers reach their individual goals. Voca provides travelers a variety of benefits including insurance, vacation, referral bonuses, and dedicated support for active travelers.

Assignment details are provided below, we’re excited to hear from you. Interested travelers (or local candidates!) will reach out to Voca at travelnurse@myvoca.com, 507-288-5260.

 

Assignment Details 

Specialty:

  • The utilization manager conducts utilization management functions including making medical necessity determinations for pre-service authorization requests, concurrent reviews and post-service reviews. Examples include reviewing pre and post-service requests for medical necessity, concurrent reviews of inpatient and outpatient facility admissions, sub-acute care, and transition to appropriate levels of care. The utilization manager communicates and discusses clinical information and plan requirements with appropriate internal and external customers.  

 

Qualifications:

  • Utilization Review nurse needed at Priority Health for a 1 year assignment. 
    Experience in UM is required as well as competence in InterQual Criteria. FACETS and Vital Systems can be taught. 

    The nurse will need to be onsite for initial training but can work remotely once they demonstrate proficiency. 

    Provides health information, interacts and acts as a resource for nursing units for complex clinical situations to ensure appropriate 
    use of acute care services and diagnosis-related group (DRG) management. Assesses appropriateness of inpatient admissions and 
    continued stay. Educates medical staff/other health care professionals regarding utilization management and quality requirements. 
    Makes recommendations and provides financial and utilization management (UM) information to other members of the care 
    facilitation teams for work prioritization. Works closely with inpatient care facilitators and Medical Social Workers to move patients 
    through the continuum appropriately. 

    Please note, this position does not allow for expenses.

Partnering with Voca comes with a number of benefits including:

  • Dedicated Recruiter
  • Paid Vacation Program
  • 401(k) Program
  • Insurance Options
  • Competitive, Flexible Pay Packages
  • Housing Location Assistance
  • Excellent Referral Programs


Voca Health
Phone 507-288-5260
Email travelnurse@myvoca.com
Voca: The Spirit of Work

IND-AF

Ashley Applen

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