Full employer posting
In Utilization Management at Main Campus Lee Building Work schedule will be Full-time on the Day Shift, Monday - Friday 8:00am - 4:30pm on call rotating weekend coverage.
The Nurse Reviewer 3 is responsible for performing inpatient admission reviews, concurrent reviews, and observation reviews primarily for BCBS AL patients, based on InterQual criteria and local policies. However, Nurse Reviewer 3 should also be capable of performing such reviews for AL Medicaid and other commercial payers if needed. Credentials with Equivalent
Essential: * Registered Nurse AL Single State or any of the following equivalent qualifications below: - Registered Nurse AL NLC Multi State - Registered Nurse Non-AL NLC Multi State * Basic Life Support Education with Equivalent
Essential: * Associate of Science Nursing in Nursing Experience with Equivalent
Essential: * 5 Years Staff Level
About the role
The Nurse Reviewer 3 is responsible for performing inpatient admission reviews, concurrent reviews, and observation reviews primarily for BCBS AL patients, based on InterQual criteria and local policies. However, Nurse Reviewer 3 should also be capable of performing such reviews for AL Medicaid and other commercial payers if needed.