Position Summary:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required.
The Utilization Review Nurse, reporting to the Revenue Cycle Director, provides the professional assessment and reporting of complex acute clinical datasets to various agencies internally and externally. This individual works with numerous business and clinical units across the corporation to ensure the timely interpretation and processing of business rules. The UR Nurse will report on workload activity, challenges that prevent processing or approval of days, and provides decision support on opportunities for improvement in the entire Utilization Review process. This individual must have excellent communication, time management, and networking skills in working with clinical providers and financial decision makers.
Position Qualifications: Bachelor's Degree in Nursing. Degree requirements may be waived on a year for year basis for a combination of experience and education. 5 years nursing experience required. 3 years Revenue Cycle experience preferred. Registered Nurse. License must be and remain in good standing in the State of Alaska. Continuing education may be supported in the workplace, however it is the responsibility of the incumbent to take all necessary steps to maintain their licensure. Must have Certification Professional in Healthcare Management or the ability to acquire within 2 years of employment. Benefits Include: Generous PTO beginning at 4.5 weeks Eleven paid holidays Comprehensive healthcare coverage Life and Disability Insurance Flexible Spending Account School loan repayment eligibility Tort Claims coverage Retirement plans Employee Wellness Center $30,000 Sign On Bonus with a three year agreement*. C#