Supervisor Utilization Review

In Utilization Management at Main Campus Lee Building Work schedule will be Full-time on the Day Shift, Monday - Friday 8:00am - 4:30pm on call rotating weekend coverage. Summary: The Nurse Reviewer 3 is responsible for performing inpatient admission reviews, concurrent reviews, and observation reviews primarily for BCBS AL patients, based on InterQual criteria and local policies. However, Nurse Reviewer 3 should also be capable of performing such reviews for AL Medicaid and other commercial payers if needed. Essential: Credentials with Equivalent Qualifications: 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 Basic Life Support Essential: Education with Equivalent Qualifications: Associate of Science Nursing in Nursing Essential: Experience with Equivalent Qualifications: 5 Years Staff Level Schedule: Monday - Friday 8:00am - 4:30pm on call rotating weekend coverage, Day Shift, 8-Hour Shifts