MHM Services, Inc.

  • Utilization Review Nurse

    Job Locations US-AZ-Tempe
    Posted Date 1 month ago(4/18/2019 12:52 PM)
    Job ID
    2019-11090
  • Overview

                                                                         Utilization Review RN

                                          Come be a part of something new and different!

     

    Centurion has just been awarded the AZ DOC medical, MH and dental contract.  Here we grow again!  We have an opportunity for a  RN Utilization Management Nurse to join the team at our Regional Office located in Tempe, AZ. The UR RN will work from our regional office and will perform utilization review on inpatient hospitalizations, as well as request for authorization of medical services including diagnostic, outpatient care, and primarily inpatient hospital services using defined InterQual criteria.

     

    Job Duties and Responsibilities:

    • Review faxed or telephonic information to determine the level of care or the medical necessity of any services requested by a provider either inpatient or outpatient.
    • Review and audit patients/inmates medical records to determine what services or procedures are medically necessary.
    • Utilize nationally recognized evidence based criteria, InterQual, to determine medical necessity of the requested services, diagnostics, specialty care or inpatient care.
    • Refer provider requests to the Medical Director or designee when the requested services do not meet the recognized criteria.
    • Coordinate with healthcare staff and providers to plan for discharge back to DOC institutions on all inpatient hospitalizations.

                      We offer an excellent compensation and comprehensive benefit package. 

    Come grow with us in this unique opportunity.   

     

    For additional information, contact Angie Oostendorp at 636/922-5566 or at angie@teamcenturion.com.

     

     

    Qualifications

    • Current AZ RN license
    • Utilization management/review experience
    • Experience with concurrent and retro review, prior authorization, and case management preferred
    • Clinical nursing experience >5 years
    • Experience using medical management software programs preferred, computer savvy required
    • InterQual experience/certification is highly desired
    • Experience working with correctional healthcare a plus
    • Must be able to pass background investigation and obtain agency security clearance

    INDMHM

    #ZR4

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