Utilization Review Nurse
Independent Health - Buffalo, NY

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**Please note: This position is with Nova, a division of Independent Health Corporation (a subsidiary of Independent Health).**

The Utilization Review Nurse performs clinical reviews to determine the medical necessity of requested services. The URN obtains clinical information and utilizes IHA policy and/or defined criteria to determine medical necessity, as if necessary, will consult with the Associate Medical Director for all requests that do not meet criteria or IHA policy.

Requirements:

  • Active, unrestricted, and licensed registered nurse required. Associates degree in health related field; BSN preferred.

  • Three (3) years of clinical experience in acute hospital care and/or three (3) years of utilization review experience required.

  • Previous experience in managed care preferred.

  • Clinical knowledge of the health or social work needs for the population served.

  • Demonstrated ability to identify barriers to a successful care management path.

  • Demonstrated ability to interact effectively with physicians and other members of the health care system.

  • Proficient PC and Windows skills required, inlcuding MS Office.

  • Excellent problem-solving abilities and time management skills.

  • Excellent written, verbal and interpersonal communication skills.

  • Demonstrated transferable knowledge, skill and ability to complete job duties independently and proficiently. Flexibility in work schedules and assignments.

  • Maintains confidentiality and uses only the minimum amount of protected health information (PHI) necessary to accomplish job related responsibilities.

  • Other duties as needed. Every associate is given a job description upon hire outlining the qualifications, duties, and pay grade of the position. Independent Health reserves the right to change job descriptions as necessary.


  • Independent Health is an equal opportunity employer.

    Independent Health - 14 months ago - save job - block
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