Supervisor Utilization Review

Children's of Alabama
  • Birmingham, AL
    18 days ago

    Job Description

    Supervisor Utilization Review

    Main Campus Lee Building Day Shift Utilization Management Req # 2463 Location 1620 4th Avenue South, Lee Building, Birmingham, Alabama Category Clinical Professional Schedule Full Time Work Schedule 8-Hour Shifts Schedule Description Monday - Friday 8:00am - 4:30pm on call rotating weekend coverage

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    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.

    Summary:

    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 Qualifications:

    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 Qualifications:

    Essential:

    • Associate of Science Nursing in Nursing

    Experience with Equivalent Qualifications:

    Essential:

    • 5 Years Staff Level

    Schedule: Monday - Friday 8:00am - 4:30pm on call rotating weekend coverage, Day Shift, 8-Hour Shifts

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    Numbers & Facts

    LocationBirmingham, AL

    Skills

    • Basic Life Support (BLS)unmatched
    • Medicaidunmatched
    • Nursingunmatched
    • Patient Careunmatched
    • Registered Nurse (RN)unmatched
    • Utilization Managementunmatched

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