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Utilization Review Nurse (RN/L...

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Job Summary

Sedona Group
San Marcos, TX 78666
Staffing/Employment Agencies
Job Type
Full Time
Education Level
Career Level
Experienced (Non-Manager)
19.23 - 26.44 $ /hour
Contact Information
Sedona Group
Phone:  512-393-3200
Fax:  512-393-3220

Utilization Review Nurse (RN/LVN)

About the Job

Job Title: Utilization Review Nurse

Job Summary

A Utilization Review Nurse position is a full-time, (up to 50 hours per week) and is a salaried position. The primary function of a Utilization Review Nurse is to review and analyze medical records for med-legal reviews and provide clinical documentation. Utilization Review Nurses must create a professional executive report which includes a summary, appropriate criteria/guidelines, and a rationale based on evidence based guidelines. The executive summary will review the patient’s condition, physician's orders, summarize and discuss course of treatment and substantiate necessity of treatment based on evidence based guidelines. Additional information may be needed in reports based on the needs of our clients requiring information. Utilization Review Nurses are responsible for amending their reports with any additional clinical information and are required to maintain an average daily case load of 25-30 cases. 


Minimum Requirements

1. Be on time and ready to work every day

2. LVN or RN with current licensure

3. Completion of  Assessment Test

4. General Typing Skills of 45wpm

5. Knowledge of Microsoft Office 2003 (or more recent)

6. Willing to learn and be trained on medical/surgical procedures

7. Knowledge of basic anatomy

8. Ask for help when needed

9. Be a team player by supporting others in a team environment

10.Observe and respect the organizational flow of the office

11.Sign and abide by the confidentiality agreement and Employee Handbook


Essential Job Functions

1. Comprehension of medical/surgical modalities and imaging techniques

2. Analysis of clinical documentation in relation to medico-legal review

3. Interpret and apply appropriate guidelines to medico-legal reviews

4. Use logic and reasoning to determine and utilize appropriate evidence based guidelines

5. Perform a low to moderate amount of research on a case by case basis

6. Create a high-quality, professional report, free of grammar or spelling errors

7. Dictate all reports

8. Reach and maintain a 25-30 average case load per day after training

9. Maintain a monthly Quality Assurance score of 99% or higher


*To Apply:  Email your resume to careershere@sedonagroup.com and Apply on-line at www.sedonacompass.com (be sure EACH section is COMPLETE). You may also call our office @ 512-393-3200 to speak with a Staffing Specialist.



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