Utilization Review Nurse

Brooklyn Park, MN
Jan 24, 2018
Nov 17, 2018
Job Type
Employment Status
Full Time

As a Utilization Review Nurse, you will:
• Act as a liaison between the clinical treatment team and third party payers to promote appropriate treatment for psychiatric illness and any other prescribed needs
• Review the need for denial of stay with assigned clinical treatment team when patient no longer meets acute care criteria and facilitate appropriate action upon denial
• Maintain currently knowledge level on contract requirements of all third party payor groups
• Track each patient’s course of treatment through inpatient, partial hospitalization and IOP programs

• Knowledge of nursing practices, gained through at least one year of nursing school
• Current license with the Minnesota State Board of Nurse Examiners
• Knowledge of and able to follow the Nurse Practice Act and the UR Standards of Excellence
• Oriented and educated in gender, culture and age appropriate care
• Ability to display a professional attitude in all aspects of nursing performance
• Previous Utilization Review experience preferred
• Proficient in Microsoft Office programs including Word and Outlook

*Background in Medicaid Practices would be ideal for this position*

PrairieCare is a physician-owned and operated psychiatric healthcare system experiencing rapid growth in the Twin Cities. With multiple sites across the Twin Cities, PrairieCare has quickly grown to become one of the State’s largest providers of mental health services to children, adolescents and their families. 
Please no phone calls

PrairieCare does not discriminate against any person on the basis of race, color, national origin, disability or age in admissions, treatment or participation in its programs, services and activities or employment. PrairieCare is an Affirmative Action Employer/Equal Opportunity Employer supporting Veterans, Disabled and other protected individuals and is committed to a diverse workforce. Offers of employment from PrairieCare are conditional and contingent upon successful clearance of all background studies.

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