Quality Utilization Reviewer I

Company: Children's of Alabama
Location: Birmingham
Posted on: January 27, 2023

Job Description:

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

Keywords: Children's of Alabama, Birmingham , Quality Utilization Reviewer I, Other , Birmingham, Alabama

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