FREE ACCESS
5,000–10,000 jobs/day
See all jobs on JobTailor
Search thousands of fresh jobs every day.
Discover
- Fresh listings
- Fast filters
- No subscription required
Create a free account and start exploring right away.
Utilization Review Nurse – Utilization Management
ProMedicaUtilization Management RN maximizing quality and cost-efficiency of health care services at ProMedica. Collaborating with the healthcare team for reviews, authorizations, and service utilization improvements.
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in acute care nursing, case management, and utilization review, with a strong understanding of insurance guidelines and payer rules. Proven ability to collaborate effectively with healthcare teams to enhance service utilization and cost-efficiency.
Highest-signal resume keywords
Acute Care Nursing ExperienceCase ManagementUtilization ReviewInterQual CriteriaRN License
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Utilization ReviewCase ManagementPayer RulesInsurance GuidelinesAcute Care Nursing
Soft Skills
CollaborationCommunication
Certifications & Qualifications
RN License
Industry Keywords
Health Care ServicesHospital Service UtilizationUR/UM
About the role
Key responsibilities & impact- maximize the quality and cost-efficiency of health care services at ProMedica
- complete reviews for admissions and transfers
- apply payer rules to obtain authorizations
- work with physicians, nurses, and other members of the health care team
- review cases and look for opportunities to improve hospital service utilization
Requirements
What you’ll need- Graduate of approved NLN accredited School of Nursing
- Minimum of 3 years acute care nursing experience
- Current RN licensed in the state of hire
- Knowledge of insurance guidelines
- experience with UR/UM in hospital acute care setting
- Previous experience with case management
- utilization review and InterQual criteria
Benefits
Comp & perks- dental
- vision
- company paid life insurance
- paid time off
- a 401k retirement plan
- an employee assistance program
- other voluntary coverage options
- employee discounts