Utilization Review Nurse (U/R Nurse)

Washington D.C.
Mar 20, 2018
Apr 30, 2018
Full Time

We are recruiting Full-Time long term contract RNs to perform Utilization Review for DC residents in on-site nursing homes. The RNs will be doing the following:

  • Assesses the medical necessity and quality of inpatient admissions, outpatient services, surgical and diagnostic procedures, and other covered services by conducting pre-certification, concurrent, and retrospective reviews
  • Applies clinical review criteria, guidelines, and screens in determining the medical necessity of health care services
  • Consults with physician/practitioner consultants when reviews fail clinical review criteria, guidelines, and screens
  • Refers cases to other professionals internally, as well as to customers and other appropriate external sources when indicated
  • Meets performance expectations on quality metrics
  • Meets performance expectations on quantity metrics
  • As appropriate, provides daily oversight and monitoring of non-clinical staff during their performance of non-clinical support activities; also provides the supervisor with input regarding employees’ performance of these activities.

These are Full-Time 40 hours per week positions. Our Client will provide all RNs with a company laptop. Dependable transportation is required. Mileage reimbursement is available after 1st patient visit each day. (Weekly reports are required to be submitted by RNs) RNs MUST have a current DC License. The contract hourly pay rate is $37.71 and NO overtime will be required.



All candidates must be computer savvy with intermediate Word, Excel, and Outlook along with experience emailing & texting from a Smartphone. Qualified applicants will be REQUIRED to complete online assessments in the above software prior to an initial interview.

We are only reviewing candidates with a MINIMUM of 3 years of Chart Review/ Utilization Review experience, preferably in an Acute Care Hospital and/or Skilled Nursing Facility. In addition, all RNs must have a valid (or renewable) DC License. Paid Training/Orientation will take place in DC at a Metro accessible location. We are hiring immediately, please submit your resume for immediate and confidential review.

Please email you resume to mrobinson@nri-staffing.com


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