Quality Utilization Reviewer I - Children's of Alabama
Birmingham, AL
About the Job
- Job Summary
- The UR Reviewer 1 is responsible for performing inpatient admission, concurrent, and observation reviews based on pre-established criteria exclusively for Medicaid and commercial payers other than BCBS AL. Upon successful completion of training by UR Reviewer 2 and with approval of UM Manager & Department Director, UR Reviewer 1 with RN licensure may advance to Nurse Reviewer 2 (If position becomes available).
- Education
- Graduate of an accredited School of Nursing or Social Work.
- Experience
- 2 years experience in hospital setting or related field (i.e. 3rd party payer)
- Utilization review experience preferred.
- Licensures, Certifications, and/or Registries
- Current AL licensure as LPN, RN or LCSW
Location: Children's of Alabama ยท Utilization Management
Schedule: On-call/Flexi, Day/Evening shift, Day/ Evening shift as needed
Source : Children's of Alabama