Quality Utilization Reviewer I

• Job Summary The UR Reviewer 1 is responsible for performing inpatient admission, concurrent, and observation reviews based on pre-established criteria exclusively for Medicaid and commercial payers other than BCBS AL. Upon successful completion of training by UR Reviewer 2 and with approval of UM Manager & Department Director, UR Reviewer 1 with RN licensure may advance to Nurse Reviewer 2 (If position becomes available).
• Education Graduate of an accredited School of Nursing or Social Work.
• Experience 2 years experience in hospital setting or related field (i.e. 3rd party payer) Utilization review experience preferred.
• Licensures, Certifications, and/or Registries Current AL licensure as LPN, RN or LCSW

Additional Information

Main Campus Children's of Alabama