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Utilization Review (UR) Nurse - (243113)

Universal Health Services


Location:
RENO, NV
Date:
11/16/2017
2017-11-162017-12-15
Job Code:
4052
Universal Health Services
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Job Details

Deltek Talent Management - Utilization Review (UR) Nurse - (243113)

Job Details


Utilization Review (UR) Nurse - (243113)

Facility Name
Location
RENO, NV 89509 US (Primary)
Career Area
Professional
Category
Other
Job Description
Universal Health Services, Inc. (UHS) is one of the nation's largest and most respected health care management companies, operating through its subsidiaries acute care hospitals, behavioral health facilities and ambulatory centers nationwide. Founded in 1978, UHS subsidiaries now have more than 65,000 employees. The UHS business strategy is to build or purchase health care properties in rapidly growing markets and create a strong franchise based on exceptional service and effective cost control. Our success comes from a responsive management style and a service philosophy based on integrity, competence and compassion. Prominence Health Plan, established in Reno in 1993 as St. Mary’s Health Plan, was acquired in 2014 by Universal Health Services (UHS), one of Fortune Most Admired Companies. In addition to the HMO, Prominence Health Plan also offers Point of Service health plans, a preferred health insurance company that offers Preferred Provider Organization (PPO) health plans, and CDS Group Health, a third-party administrator. We are a fast-growing, rapidly-changing healthcare organization offering the excitement of a start-up with the support of a Fortune 500 company.We are looking for talented, enthusiastic people to help shape the future of our organization. Job Summary: The Utilization Review (UR) Nurse is a registered nurse who reviews and evaluates clinical cases for appropriateness against established criteria and published medical evidence. The UR Nurse, using clinical and operational knowledge, assesses needs and coordinates resources within and outside the benefit plan to promote optimal health benefits and outcomes (both clinical and financial). The Nurse reviews requests for medical services, referring to the Medical Director those that require additional expertise. Measures and reviews performance outcomes, proposes and implements improvement processes and system enhancements to achieve desired results. Identifies appropriate resources and demonstrates knowledge in managing each case and maintains accurate records, and provides timely verbal and written reports as directed.
Job Requirements
Regulatory Requirements: • Graduation from an accredited nursing education program. • Licensed by the State of Nevada to practice as a Reg
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