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UF Health Shands Hospital - Gainesville

Gainesville, Florida

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Lancaster, Pennsylvania

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York General

YORK, Nebraska

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LINCOLN, Nebraska

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New Canaan, Connecticut

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Attleboro, Massachusetts

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Pasadena, California

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Hampton Roads, Virginia

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Memphis, Tennessee

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Valhalla, New York

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Utilization Reviewer RN | Weekend only, part time with Benefits
OverviewSt. Luke's Health System is seeking an Utilization Reviewer to join our Utilization Management team. The Utilization Reviewer - RN is responsible for evaluating medical necessity for patient hospitalization and acting as an internal resource for patient care. Ensures that utilization functions are complying with hospital procedures and federal regulations.Responsibilities Conducts timely clinical decision review for services requiring prior authorization in a variety of clinical areas, including but not limited to surgical procedures, Medicare Part B medications, Long Term Services and Supports, and Home Health. Reviews the medical necessity of admission, continued hospitalization, length of stay, and any potentia


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