Utilization Review Nurse
Milford, MA32 hours, 8a-430p varied days, EO/ WE+Hol
About Us
Milford Regional Medical Center is a full-service, community and regional teaching hospital located in Milford, Mass. and serves patients from more than 20 towns in Central Massachusetts. The 149-bed medical center is a nonprofit, acute-care facility, where more than 300 primary care and specialty physicians are committed to providing exceptional healthcare services to our community with dignity, compassion, and respect.
Statement of Purpose:
The Utilization Review Nurse is responsible for utilization management at MRMC. The UR nurse performs reviews of current inpatient services and determines medical appropriateness of inpatient and observation services following evaluation of medical guidelines and benefit determination. In addition, the UR Nurse will also manage the denial and appeal process under the guidance of the UR Manager.
Qualifications:
Education:
Bachelor of Science in Nursing required
Masters in Healthcare preferred
Certification/License:
Massachusetts Registered Nurse licensure required
Certified Case Manager, preferred
Experience:
Minimum of 5 years acute or critical care experience
Minimum of 1 year Nurse Case Management experience
Minimum of 1 year Utilization Review Nurse Experience including solid working knowledge with InterQual criteria
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