ResponsibilitiesPerform initial admission and continued stay reviews utilizing InterQual and MCG using evidenced-based criteria to identify and support the appropriate level of careAbstract data from a variety of medical records to ensure accurate clinical dataAdhere to established quality, timeliness, and productivity outputs required in the completion of first level nursing utilization reviewEnsure effective communication internally and externally while delivering excellent customer servicePerform other duties as assigned by departmental leadership in support of departmental and organizational strategies and goals which may include system testing, training and other opportunities that promote growthComplete and maintain annual compliance and annual HIPAA trainingParticipate in organizational educational offerings and required training as needed to support service deliveryRequired QualificationsBachelor's DegreeMust have a current Registered Nurse license2 years of recent hospital-based Utilization Review preferredAt least 3 years of clinical nursing experience (practice)Knowledge of current Medicare rules and regulations related to Utilization ReviewStrong analytical, organizational and time management skillsAbility to work independently with limited supervisionExcellent clinical abstraction and attention to detailExperience with InterQual and/or MCG is preferredMust be willing to work a variable schedule that encompasses evenings, days, weekends, and holidays. The Company's employment practices, including those regarding recruitment, hiring, assignment, promotion, compensation, benefits, training, discipline, and termination shall not be based on any person's age, color, national origin, citizenship status, physical or mental disability, medical condition, race, religion, creed, gender, sex, sexual orientation, gender identity and/or expression, genetic information, marital status, status with regard to public assistance, veteran status or any other characteristic protected by federal, state or local law.