RN Utilization Review Specialist

Minimum Qualifications

Associate Degree in Nursing

2 of the most recent 4 years’ working in an acute care setting

Proficient in word processing and PC based spreadsheet programs

Licensure, Registration, Certification

One of the following

• Current Alabama RN license
• Current Multi State RN License in accordance with Nurse Licensure Compact (NLC) for Alabama*
• Infirmary Health abides by the NLC requirements and guidelines for the state of Alabama

For specific areas CRRN (Certified Rehabilitation RN) is required (or eligibility)

Desired Qualifications

BSN

Some background in management, clinical education or case management

Desired Licensure, Registration, Certification

National certification applicable to area of clinical practice

Improves overall quality and completeness of clinical documentation by performing concurrent review of the medical record to ensure medical necessity and appropriateness of hospital admissions. Provides education to physicians and others to improve the capture of clinical severity for the level of service rendered. Identifies process improvement opportunities and supports the timely and accurate capture of measurements to improve patient outcomes.