Utilization Review Nurse

*Who we are:* Diverse Lynx, based in Princeton, NJ, is a Healthcare Staffing agency serving a broad array of U.S. healthcare facilities, from hospitals and clinics to labs and nursing homes. Committed to excellence and diversity, we're an equal opportunity employer, welcoming talent irrespective of race, color, religion, gender, or any other protected status.

*Job Summary*

As a Utilization Review Nurse, you will play a crucial role in assessing the quality and necessity of healthcare services provided to patients. You will work closely with healthcare providers to ensure that patients receive appropriate care while managing costs effectively.

*Duties*
* Conduct utilization reviews to evaluate the medical necessity and efficiency of healthcare services
* Collaborate with healthcare providers to determine the most effective treatment plans for patients
* Review patient medical records and documentation to ensure accuracy and compliance with regulations
* Utilize electronic health record systems such as Cerner for data management and analysis
* Focus on various specialties including pediatrics, hospital care, clinics, and case management
* Apply knowledge of ICD-9 coding and Medicare guidelines in the review process

*Experience*
* Previous experience in utilization review, case management, or a related field is preferred
* Strong understanding of health information management practices
* Ability to assess patient care needs and make informed decisions based on clinical data
* Excellent communication skills to interact with healthcare professionals and patients effectively

*Years of Experience: *5 year(s)

*Certifications Required:*
CA RN License
CA RN License

Job Types: Full-time, Contract

Pay: $70.00 - $75.00 per hour

Expected hours: 40 per week

Benefits:
* Referral program
Schedule:
* 8 hour shift
* Day shift

Work Location: In person