We are seeking a meticulous Utilization Review Nurse to ensure the appropriateness and medical necessity of healthcare services. The Utilization Review Nurse will review patient records, assess treatment plans, and collaborate with healthcare providers to optimize resource utilization and ensure compliance with established guidelines. This role requires a detail-oriented individual with strong analytical skills and a commitment to promoting cost-effective, high-quality care.

Key Responsibilities:

• Review patient records and assess treatment plans.
• Ensure compliance with established guidelines and regulations.
• Collaborate with healthcare providers to optimize resource utilization.
• Identify and resolve utilization management issues.

Required Skills:

• Clinical assessment and analytical skills.
• Knowledge of healthcare regulations and guidelines.
• Strong communication and interpersonal skills.