Fusion HCR

Utilization Review Nurse

Fusion HCR  •  Las Vegas, NV (Onsite)  •  2 months ago
Apply
Save Job
Mark Applied Mark Interviewed Mark Offered
Hide Job Report Job
AI can make mistakes so check important info. Chat history is never stored.

Job Description

Fusion HCR is hiring!  Direct Hire – Utilization Review Nurse, this is an onsite position, working with our client in Acute Care. 


Seeking an experienced Utilization Review Nurse (RN) to review patient admissions for medical necessity, appropriate level of care, and compliance with payer guidelines. This role works closely with clinical teams to ensure efficient resource utilization and quality patient outcomes. Responsibilities
  • Review admissions using InterQual and/or Milliman criteria
  • Evaluate medical necessity, level of care, and documentation accuracy
  • Ensure compliance with Medicare, Medicaid, and regulatory guidelines
  • Collaborate with physicians, case management, and care teams
  • Support discharge planning and care coordination
  • Document findings and communicate recommendations
Requirements
  • Active RN license (Nevada)
  • 5+ years acute care nursing experience
  • 3+ years Utilization Review experience
  • 3+ years discharge planning experience (acute care)
  • Experience with InterQual (must be able to pass exam)
  • Experience with Milliman guidelines
Preferred
  • Background in Case Management or CDI
  • Strong knowledge of Joint Commission and CMS guidelines
Why Apply
  • Competitive pay
  • Stable, high-demand role
  • Collaborative healthcare environment
Apply Now
If you have strong Utilization Review, InterQual, and acute care experience, we want to hear from you!

Fusion HCR

About Fusion HCR

Fusion HCR is a boutique staffing and solutions firm that sets itself apart by providing the highest quality candidates in an unrivaled timeframe.

We specialize in Technology, Accounting & Finance, Administrative Services, Construction Management, and Clinical professionals for the following industries; Manufacturing, Hospitality/Gaming, Government, Healthcare, Construction, Telecommunications and IT Services industries and many more.

Fusion HCR takes pride in staying ahead of the industry by aligning it's strategy, resources, processes, and technology to provide the highest quality talent solutions from a highly experienced team. When you choose Fusion HCR, you are choosing a trusted and valuable partner committed to your success.

Industry
HR & Recruiting
Company Size
11-50 employees
Headquarters
Springboro, Ohio
Year Founded
2012
Website
fusionhcr.com
Social Media