SUMMARY: The UR/denials nurse conducts chart reviews to ensure medical necessity, appropriateness of admission, continued length of stay and level of care using clinical information and clinical criteria. The role also participates in the denial management process as well.

The UR/denials nurse conducts chart reviews to ensure medical necessity, appropriateness of admission, continued length of stay and level of care using clinical information and clinical criteria. The role also participates in the denial management process as well.

Minimum 2-3 years experience in Case Management or related healthcare field SPECIAL

Computer Proficiency OTHER: Excellent communication, interpersonal, organizational and presentation skills LICENSE/CERT: Required: RN (Registered Nurse) State of Missouri Preferred: CCM (Certified Case Management)

Required: Bachelors - Nursing

DAYS shift

Case Manager - Utilization Rvw

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